Muscle Ultrasound in Clinical Neurology: Diagnostic Uses and Guidance of Botulinum Toxin Injection

Muscle ultrasound (MUS) is increasingly used by neurologists, neuropediatricians, neurosurgeons, specialized radiologists and anaesthesiologists for the imaging-supported diagnosis of neuromuscular disorders. Especially, MUS highly sensitive in detecting fasciculations motor neuron diseases, revealing intensive care unit acquired weakness. Hereditary inflammatory myopathies are associated with distinct patters echo-intensity changes affected muscles. Moreover, can be guiding needle biopsy muscle lesions, targeting intramuscular botulinum neurotoxin (BoNT) injection neurological disorders hyperactivity. MUS-guidance BoNT especially recommendable complex cervical dystonia, task-related hand dystonia (writer’s cramp, musician dystonia), children adolescents cerebral palsy. Modern technologies such as sono-elastography, tissue Doppler, high-definition microvasculature imaging allow novel diagnostic therapeutic uses. Recently, an international expert group reported consensus guidelines training. The present review provides a concise overview well-established applications clinical neurology, specific focus at injections.