The Ultrasound pattern sum score – UPSS. A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves

• Published in: Clinical neurophysiology Vol. 126; no. 11; pp. 2216 - 2225
• Main Authors: Grimm, Alexander, Décard, Bernhard F, Axer, Hubertus, Fuhr, Peter
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 01.11.2015
• Subjects: Acute Disease; Adult; Aged; Case-Control Studies; Diagnosis, Differential; Female; Humans; Inflammatory neuropathy; Male; Middle Aged; Nerve enlargement; Nerve ultrasound; Neurology; Peripheral Nerves - diagnostic imaging; Peripheral Nervous System Diseases - classification; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - diagnostic imaging; Polyneuropathies - classification; Polyneuropathies - diagnosis; Polyneuropathies - diagnostic imaging; Polyneuropathy; Prospective Studies; Retrospective Studies; Sensitivity and Specificity; Severity of Illness Index; Ultrasonography - methods; Ultrasound pattern; Ultrasound score; chronic inflammatory demyelinating polyneuropathy; CMAP; AMAN; millisecond; sensory nerve action potential; micro volt; Guillain–Barré syndrome; mV; CSA; m/s; Ultrasound pattern; multifocal motor neuropathy; PNP; MADSAM; CSF; cross sectional area; conduction velocity; GBS; μV; acute motor axonal neuropathy; UPSS; Ultrasound score; ms; polyneuropathy; GvHD; milli volt; AIDP; CIP; critical illness polyneuropathy; SNAP; CIDP; ultrasound pattern sum score; MMN; compound muscle action potential; Nerve enlargement; CV; cerebrospinal fluid; meter per second; multifocal acquired demyelinating sensory and motor neuropathy; Inflammatory neuropathy; acute inflammatory demyelinating polyneuropathy; Nerve ultrasound; graft versus host disease; Polyneuropathy
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2015.01.011

Highlights • The recently described ultrasound findings in several neuropathies of heterogeneous origin make classification with pattern analysis necessary. • The ultrasound pattern sum score (UPSS) and its sub-scores UPS-A, -B and -C enable a differentiation of several acute and subacute axonal and demyelinating neuropathies. • Enlarged cervical nerve roots and/or the vagus without or with only slight enlargement of the peripheral nerves enable a differentiation from GBS and subacute onset CIDP.