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- W4367304848 abstract "<h3>Objective:</h3> Case series highlighting utility of neuromuscular ultrasound (NMUS) in diagnosis of various peripheral nerve pathologies with inconclusive or normal EMG/NCS results <h3>Background:</h3> NA <h3>Design/Methods:</h3> Case Series <h3>Results:</h3> <h3>Case 1:</h3> 43-year-old man with history of left arm trauma in childhood presented with numbness in left 4th and 5th fingers. EMG/NCS showed mild left median neuropathy at the wrist and a poorly localized left ulnar neuropathy. NMUS showed a post-traumatic neuroma in the ulnar nerve in the upper arm. <h3>Case 2:</h3> 49-year-old woman presented with left 4th and 5th finger pain, numbness, weakness in left mid-forearm after a recent left arteriovenous graft revision surgery. EMG/NCS showed left ulnar nerve dysfunction with unclear localization. NMUS demonstrated pseudoaneurysm of ulnar artery compressing the ulnar nerve. <h3>Case 3:</h3> 62-year-old man with stable chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), not on IVIg, presented with worsening grip strength and numbness. EMG/NCS showed bilateral focal compressive ulnar neuropathies at the elbows. NMUS confirmed ulnar neuropathy and patchy multifocal enlargement in bilateral median nerves at atypical sites for compression, consistent with CIDP. <h3>Case 4:</h3> 81-year-old woman with a leiomyoma on right leg presented with intermittent shock-like pain. EMG/NCS was normal. NMUS revealed the mass’s proximity and positive sonographic Tinels’ sign over tibial nerve reproducing the patient’s symptoms. <h3>Case 5:</h3> 67-year-old woman with neurofibromatosis 1 presented with multifocal right upper arm pain and radiating paresthesia. EMG/NCS was normal. NMUS showed abnormal plexiform changes at ulnar nerve and small schwannomas at radial nerve with positive sonographic Tinel’s sign reproducing the patient’s symptoms. <h3>Conclusions:</h3> NMUS is a reliable and non-invasive tool that can add information that cannot be obtained from electrodiagnostic studies. This case series shows that when electrodiagnostic tests are unclear and a high clinical suspicion is present, NMUS helps establish accurate diagnosis of a wide variety of peripheral nerve pathologies and can meaningfully impact management. <b>Disclosure:</b> Dr. Kim has nothing to disclose. Dr. Patterson has nothing to disclose. Dr. Abrams has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Averitas Pharmaceutical." @default.
- W4367304848 created "2023-04-29" @default.
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- W4367304848 date "2023-04-25" @default.
- W4367304848 modified "2023-09-26" @default.
- W4367304848 title "Utility of Diagnostic Neuromuscular Ultrasound in Unrevealing Electrodiagnostic Studies: Case Series (P1-8.012)" @default.
- W4367304848 doi "https://doi.org/10.1212/wnl.0000000000201781" @default.
- W4367304848 hasPublicationYear "2023" @default.
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