scholarly journals A Case of Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain-Barré Syndrome, with Possible Syndrome of Irreversible Lithium-Effectuated Neurotoxicity

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
David Y. Liu ◽  
Jessica R. Hollenbach ◽  
Jason A. Gregorin ◽  
Jonathan H. Wynbrandt
Keyword(s):  
Prolonged Mechanical Ventilation ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Respiratory Compromise ◽  
Term Care ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
Immune Globulins ◽  
Prolonged Recovery ◽  
Guillain Barré

Acute Motor Sensory Axonal Neuropathy (AMSAN) is a rare and severe variant of Guillain-Barré syndrome (GBS) that has a prolonged recovery course. GBS is often suspected due to ascending muscle weakness, sensation difficulties, respiratory compromise, and antecedent diarrhea. The diagnosis of GBS is supported by cerebrospinal fluid analysis showing albuminocytologic dissociation. Electromyogram and nerve conduction study confirm the diagnosis and allow for further classification by variant. Treatment involves either IV immune globulins or plasmapheresis, and patients typically recover. However, depending on the variant and severity, patients may ultimately require prolonged mechanical ventilation with tracheostomy. In these cases, they may continue to have persistent muscle and sensation abnormalities requiring long-term care. We present a unique case of a 38-year-old female patient with decade-long use of lithium for bipolar disorder that presented with acute lithium toxicity. Though she was ultimately diagnosed with AMSAN, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) may have also contributed to her persistent neurological sequelae.

scholarly journals A case of a recurrent GBS

2017 ◽  
Vol 5 (2) ◽  
pp. 135-138
Author(s):  
Md Mahabub Morshed ◽  
AKM Ferdous Rahman ◽  
Syed Tariq Reza ◽  
Muhammad Asaduzzaman ◽  
Mohammad Selim ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Past History ◽  
Complete Recovery ◽  
Guillain Barre Syndrome ◽  
Respiratory Compromise ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
History Of ◽  
Guillain Barré

Background: Guillain-Barré syndrome is an acquired polyradiculo-neuropathy, often preceded by an antecedent event. It is a monophasic disease but a recurrence rate of 1–6 % is documented in a subset group of patients.Case presentation: Thirty-five-years-old female with past history of near complete recovery following Guillain-Barré syndrome 17 years back presented with acute, ascending symmetrical flaccid quadriparasis extending to bulbar muscles and respiratory compromise needing mechanical ventilation. Nerve conduction study revealed AMAN variant of Guillain-Barré syndrome. Cerebrospinal fluid analysis done after 1 weeks during recurrent episode revealed albuminocytologic dissociation. She was treated with intravenous immunoglobulin resulting in a remarkable recovery.Conclusion: Recurrence of Guillain-Barré syndrome can occur in a subset of patients with Guillain-Barré syndrome even after many years of asymptomatic period. Most patients with recurrent GBS respond favourably to treatment with plasmapheresis or IVIG.Bangladesh Crit Care J September 2017; 5(2): 135-138

SEVERE RESPIRATORY COMPROMISE IN ACUTE MOTOR AXONAL NEUROPATHY, A RARE VARIANT OF GUILLAIN-BARRÉ SYNDROME

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A1226-A1227
Author(s):  
Dolly Patel ◽  
Shiva Arjun ◽  
RAGHAVENDRA SANIVARAPU ◽  
Jagadish Akella ◽  
Javed Iqbal ◽  
...  
Keyword(s):  
Rare Variant ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Respiratory Compromise ◽  
Acute Motor Axonal Neuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals Guillain-Barré syndrome triggered by surgery in a Chinese population: a multicenter retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiaoyu Gong ◽  
Shuping Liu ◽  
Yin Liu ◽  
Jiajia Yao ◽  
Xiujuan Fu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Orthopedic Surgery ◽  
Southern China ◽  
Axonal Neuropathy ◽  
Trigger Factor ◽  
Guillain Barre Syndrome ◽  
Initial Symptoms ◽  
Guillain Barré Syndrome ◽  
Potential Trigger ◽  
Guillain Barré

Abstract Background Surgery is a potential trigger of Guillain-Barré syndrome (GBS), a disorder which leads to an autoimmune-mediated attack of peripheral nerves. The present study was designed to explore clinical features of post-surgical GBS compared with those of general GBS in order to provide better clinical advice to patients undergoing surgery. Methods The medical records of GBS patients who were seen at 31 tertiary hospitals in southern China between January 1, 2013 and September 30, 2016 were retrospectively analyzed. Post-surgical GBS was defined as symptoms of GBS within 6 weeks after surgery. Clinical features of post-surgical GBS are described and are compared with general GBS. Results Among the 1001 GBS patient cases examined in this study, 45 (4.5%) patient cases exhibited symptoms of GBS within 6 weeks of undergoing surgery. Within this group, 36 (80.0%) patients developed initial symptoms of limb weakness. The average interval between surgery and symptom onset was 13.31 days. The most common type of surgery which triggered GBS was orthopedic surgery, followed by neurological surgery. Compared to general GBS, post-surgical GBS was characterized by a higher proportion of severe patients (Hughes functional grading scale (HFGS) score ≥ 3) upon admission and at nadir, higher HFGS scores at discharge, and longer hospital stays. Post-surgical GBS patients also had a significantly higher frequency of the acute motor axonal neuropathy subtype (37.9 vs. 14.2, respectively; P = 0.001). Conclusion Surgery is probably a potential trigger factor for GBS, especially orthopedic surgery. Infections secondary to surgery may play a role. The possibility of preceding (post-operative) infections was not excluded in this study. Clinical presentation of post-surgical GBS is characterized by a more severe course and poorer prognosis, and should be closely monitored. Trial registration chicTR-RRc-17,014,152.

Acute Motor-Sensory Axonal Neuropathy With Hyperreflexia in Guillain-Barré Syndrome

2014 ◽  
Vol 30 (5) ◽  
pp. 637-640 ◽  
Author(s):  
Ayşe Tosun ◽  
Şiar Dursun ◽  
Utku Ogan Akyildiz ◽  
Seçil Oktay ◽  
Cengiz Tataroğlu
Keyword(s):  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals Fulminant Guillain-Barré syndrome in a patient with systemic lupus erythematosus

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-226634 ◽  
Author(s):  
Eric Anthony Coomes ◽  
Hourmazd Haghbayan ◽  
Jenna Spring ◽  
Sangeeta Mehta
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Systemic Lupus ◽  
Outward Appearance ◽  
Intravenous Immunoglobulin Therapy ◽  
Neuropsychiatric Manifestation ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

A 45-year-old man with a history of systemic lupus erythematosus presented with progressive weakness and areflexia. Electromyogram revealed reduced motor and sensory amplitudes without demyelinating features. He was clinically diagnosed with the acute motor and sensory axonal neuropathy variant of Guillain-Barré syndrome. Despite intravenous immunoglobulin therapy, he deteriorated with loss of all voluntary motor function and cranial nerve reflexes. Concomitant investigations revealed class V lupus nephritis. Therapy was initiated with plasma exchange, glucocorticoids and further immunosuppression, with gradual neurological recovery. We present the first documented case of fulminant Guillain-Barré syndrome as a neuropsychiatric manifestation of systemic lupus erythematosus, highlighting how immune-mediated polyneuropathy via diffuse deafferentation may mimic the outward appearance of brain death. While glucocorticoids are not indicated in idiopathic Guillain-Barré, when this neurological disorder is a consequence of systemic lupus erythematosus, immunomodulatory treatment should be initiated to prevent neurological deterioration.

scholarly journals Electrophysiology in the Guillain-Barré Syndrome: Study of 30 Cases

1970 ◽  
Vol 24 (2) ◽  
pp. 54-60
Author(s):  
NC Kundu
Keyword(s):  
Cell Count ◽  
Electrophysiological Study ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Elevated Protein ◽  
Guillain Barré Syndrome ◽  
A Cell ◽  
Guillain Barré

Thirty consecutive patients diagnosed clinically as Guillain Barré Syndrome (GBS) were enrolled in this study to see the electrophysiological patterns of GBS in Bangladeshi community. Among 30 patients, 25 were male (M: F = 5:1) and 47% patients were between 16 and 25 years of age. An antecedent event was present in 67% of patients. An elevated protein was present in 90% of cases and a cell count of up to five was present in 94% of patients. Acute inflammatory demyelinating polyradiculopathy (AIDP) was commonest (33.35%) followed by acute motor axonal neuropathy (AMAN) which constitute 26% of patients in electrophysiological study of the enrolled patients. Acute motor sensory axonal neuropathy constitutes 14% of cases in this series. (J Bangladesh Coll Phys Surg 2006; 24: 54-60)

scholarly journals Child with Guillain-Barré Syndrome Responding to Plasmapheresis: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 4-11
Author(s):  
Sarmad Al Hamdani ◽  
Fatema Yusuf Aljanabi ◽  
Maryam Isa Abdulrasool ◽  
Alaa Haitham Salman
Keyword(s):  
Axonal Neuropathy ◽  
Cranial Nerves ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Upper Limbs ◽  
Acute Motor Axonal Neuropathy ◽  
Guillain Barré Syndrome ◽  
Foley’S Catheter ◽  
Guillain Barré ◽  
First Session

Intravenous immunoglobulin (IVIG) has long been regarded as the first-line treatment for Guillain-Barré syndrome (GBS), with plasmapheresis only being reserved for severe cases or used as an additional therapy of unproven efficacy. Here, we present the case of a 9-year-old girl with acute motor axonal neuropathy (AMAN), a rapidly progressive subtype of GBS that caused her to fall into respiratory failure. The patient failed to show a response 10 days after starting IVIG, but showed rather quick improvement with plasmapheresis. She received a total of 5 sessions of plasmapheresis on alternate days over a course of 8 days. Before starting plasmapheresis, her muscle strength was 2/5 in both upper limbs and 1/5 in both lower limbs, and she was dependent on mechanical ventilation. Following the first session, her power improved from 2/5 to 4/5 in the upper limbs, and the gag and sucking reflexes were recovered. On day 3, after the second session was initiated, she was extubated successfully (having been on a ventilator for 2 weeks) and remained on continuous positive airway pressure for the next 48 h, after which she was on room air. In addition, she was having hypertension from the first day of the diagnosis (which was due to autonomic instability), which improved after clonidine to maintain her blood pressure. She was also initially having urinary retention, then was off Foley’s catheter. The patient was discharged from the hospital 2 weeks following the first session of plasmapheresis, with power grade 4/5 in both her upper and lower limbs. Her cranial nerves had recovered fully, and she was able to walk with aids.

Acute Motor Axonal Neuropathy in a 5-Month-Old Child

2019 ◽  
Vol 18 (03) ◽  
pp. 171-174
Author(s):  
Federica Sullo ◽  
Milena Motta ◽  
Pierluigi Smilari ◽  
Luigi Rampello ◽  
Filippo Greco ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Male Infant ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Prior Infection ◽  
Prevalent Form

AbstractGuillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy characterized by rapidly progressive, essentially symmetric weakness and areflexia in a previously otherwise healthy child. It is the most common cause of acute flaccid paralysis in children, and its reported incidence is 1 to 2/100,000 population. Prior infection is a well-established predating event in GBS. The commonly recognized variants of GBS are acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy, and Miller–Fisher syndrome. AIDP is the most prevalent form. As Guillain–Barrè syndrome represents an important differential diagnosis in infancy with pronounced and progressive hypotonia, we herein report a case of AMAN in a 5-month-old male infant without known exposure to immunomodulating factors or infections.

Sign in / Sign up

Export Citation Format

Share Document