Change in cross-sectional area of the median nerve with age in neonates, infants and children analyzed by high-resolution ultrasound imaging

Eur J Paediatr Neurol. 2020 Nov:29:137-143. doi: 10.1016/j.ejpn.2020.07.017. Epub 2020 Aug 14.

Abstract

Aim: To analyze age dependencies in the cross-sectional area (CSA) of the median nerve during early childhood.

Method: A total of 43 participants (32 of whom were children younger than 2 years) were included in this cross-sectional study to analyze the age dependency of the CSA of the median nerve at three locations (wrist, forearm and upper arm) using high-resolution ultrasound images.

Results: A strong and highly significant correlation was found between age and CSA (p < 0.001). When plotted, the relationship followed a logarithmic curve (p < 0.001) with a growth rate that decreases with age. Based on the regression analysis, a temporally similar increase in CSA for all three locations was found. The nerve reaches 70% of its final CSA by 2 years of age at all three locations.

Interpretation: Similar to the nerve conduction speed, the increase in CSA is greatest during the first 2 years of life. Then, the rate gradually and synchronously slows at the proximal and distal locations. Measurement of the CSA in the clinical setting might offer a new method to assess the maturation of the nervous system in infants with minimal interference.

Keywords: Children; Cross-sectional area; High-resolution nerve ultrasound imaging; Median nerve; Nerve conduction velocity; Peripheral nerve system development.

MeSH terms

  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Median Nerve / growth & development*
  • Middle Aged
  • Ultrasonography / methods*