Peripheral nerve size in normals and patients with polyneuropathy: an ultrasound study

Muscle Nerve. 2009 Dec;40(6):960-6. doi: 10.1002/mus.21431.


Ultrasound has been used for visualizing peripheral nerve pathology. Our goal was to use ultrasound to quantitate the sizes of upper extremity nerves along their length in control subjects and patients with neuropathy. We measured median and ulnar nerve cross-sectional areas (NCSA) in the arms of 190 subjects, including 100 with neuropathies and 90 controls. We found that NCSAs in healthy child and adult controls were greater with increasing height, at proximal sites, and at sites of entrapment. Nerves were enlarged in all Charcot-Marie-Tooth 1A (CMT-1A) (11 of 11; 100%), most chronic inflammatory demyelinating polyneuropathy (CIDP) (31 of 36; 86%), half of Guillain-Barré syndrome (GBS) (8 of 17; 47%), but few axonal neuropathy (7 of 36, 19%) subjects. In GBS, nerve enlargement occurred early and with minimal electrodiagnostic abnormalities in some patients. We conclude that NCSA measured by ultrasound is a quantifiable marker of nerve features that should be corrected for patient characteristics and nerve site. NCSA is generally larger in demyelinating than it is in axonal polyneuropathies.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcoholic Neuropathy / diagnostic imaging*
  • Alcoholic Neuropathy / pathology
  • Charcot-Marie-Tooth Disease / diagnostic imaging*
  • Charcot-Marie-Tooth Disease / pathology
  • Female
  • Guillain-Barre Syndrome / diagnostic imaging*
  • Guillain-Barre Syndrome / pathology
  • Humans
  • Male
  • Median Nerve / diagnostic imaging*
  • Median Nerve / pathology
  • Middle Aged
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnostic imaging*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / pathology
  • Ulnar Nerve / diagnostic imaging*
  • Ulnar Nerve / pathology
  • Ultrasonography
  • Young Adult