GBS commonly presents as an ascending motor paralysis. [neurologyindia.com]

April 10, 2018 ; 90 (15 Supplement) April 23, 2018 First published April 9, 2018, Abstract Objective: To describe an atypical presentation of AMAN Background: Guillain-Barré syndrome (GBS) typically presents as an acute sensory-motor inflammatory demyelinating [n.neurology.org]

Case Presentation: A 60‐year‐old African American man presented to hospital requesting admission for alcohol detoxification. He was a known polysubstance abuser and hepatitis C carrier. [shmabstracts.com]

The clinical presentation of GBS and ATM overlap varies extensively. [cureus.com]

We present a case in which the patient developed subacute motor and predominantly sensory neuropathy following epidural blockade. [f1000research.com]

• Severe Pain

  pain and a poorer prognosis. [elsevier.es]

  An uncommon, acute form is marked by severe pain, weakness, and wasting of proximal and distal muscles, peripheral sensory impairment, and loss of tendon reflexes. [medical-dictionary.thefreedictionary.com]

• Abdominal Obesity

  In this subgroup, hypertension and abdominal obesity also were significantly more prevalent compared with controls. [care.diabetesjournals.org]

• Pharyngitis

  Over the next few days, he had difficulty in abducting the right eye (VI nerve palsy), bi-facial paralysis (bilateral VII nerve palsy), difficulty in swallowing and weakness of pharyngeal muscles (IX and X nerve palsy), and weakness of muscles of the [neurologyindia.com]

• Hyperactive Bowel Sounds

  On examination he was agitated with hyperactive bowel sounds. Neurological examination and vital signs were normal. Labwork was significant for a blood ethanol Level of 280 mg/dL, mild transaminitis, and normal electrolytes and renal function. [shmabstracts.com]

• Cyanosis

  There was no pallor, icterus, lymphadenopathy, thyromegaly, cyanosis, and clubbing, and Jugular venous pressure was not raised. Central nervous system (CNS) examination revealed no deficiency in higher mental and cranial nerve functions. [atmph.org]

• Arm Weakness

  On hospital day 2, the patient developed ascending left-sided leg and arm weakness and numbness. That day, he developed facial muscle and bulbar weakness that progressed to an inability to speak or eat. [frontiersin.org]

• Short Arm

  Each chromosome has a short arm designated “p” and a long arm designated “q”. Chromosomes are further sub-divided into many bands that are numbered. For example, “chromosome16q24.1” refers to band 24 on the long arm of chromosome 16. [rarediseases.org]

• Numbness of the Hand

  […] of the hand and arm, which may mimic a stroke. [medical-dictionary.thefreedictionary.com]

  One day after discontinuation, the patient developed dysesthesia and numbness in both hands and lower extremities up to knee level, accompanied by substantial decrease of fine motor skills. [f1000research.com]

• Descending Paralysis

  Our patient presented with descending motor paralysis and involvement of both sensory and motor nerves. [2] There are rare variants of GBS that can present with descending paralysis with involvement of both sensory and motor nerves. [neurologyindia.com]

A detailed workup for acute transverse myelitis was initiated while he was being managed with intravenous corticosteroids. [cureus.com]

Available from: Nerve biopsy has been widely used to investigate patients with peripheral neuropathy and is often the final step in the diagnostic workup of neuropathy of unknown origin. [ijpmonline.org]

• Bartonella Henselae

  Out of seven, six cases were published after 2007. [10] It was found in the literature that the responsible organisms in etiology of concurrent GBS and ATM are mycoplasma, influenza, Bartonella henselae, and mumps. [atmph.org]

  These cases were mostly preceded by gastrointestinal infections such as Campylobacter jejuni while other cases were associated with Zika virus, Mycoplasma pneumoniae, Legionella pneumophila, Bartonella henselae, Influenza virus, and Paramyxovirus [5-10 [cureus.com]

• Legionella Pneumophila

  Neuropediatrics. 2016, 47:03-04. 10.1055/s-0036-1583638 Canpolat M, Kumandas S, Yikilmaz A, et al.: Transverse myelitis and acute motor sensory axonal neuropathy due to Legionella pneumophila: a case report. [cureus.com]

Secondary objectives of this study are 1) to assess motor and sensory disease symptoms pre- and post-treatment, 2) to examine neuropathology in peripheral nerve biopsies in response to treatment, 3) to examine cerebrospinal fluid (CSF) and to conduct [clinicaltrials.gov]

Selection criteria: We sought all randomised or quasi-randomised (alternate or other systematic treatment allocation) trials that examined the effects of any drug therapy in people with CIAP at least one year after the onset of treatment. [cochrane.org]

[…] containing phenytoin and a (co-) analgesic for the treatment of chronic pain. [peertechz.com]

Treatment Treatment is symptomatic. Children with GAN and their families usually work with a medical team that includes a pediatric neurologist, orthopedic surgeon, physiotherapist, psychologist, and speech and occupational therapists. [childneurologyfoundation.org]

Due to a favorable ratio between efficacy and safety, PEA should be considered more often as a treatment for neuropathic pain. Keywords: CIAP, polyneuropathy, treatment, neuropathic This work is published and licensed by Dove Medical Press Limited. [dovepress.com]

Furthermore, antiganglioside antibodies (anti‐GM) tend to portend a poorer prognosis. Its absence in our patient may be supportive of his good prognosis. Conclusions: Among the different subtypes of GBS the AMAN variety presents in 5%–10% of cases. [shmabstracts.com]

The prognosis and main prognostic indicators of Guillain-Barré syndrome. A multicentre prospective study of 297 patients. The Italian Guillain-Barré Group. [frontiersin.org]

Prognosis Although the clinical course initially can be severe in AMAN, recovery can be rapid. However, recovery may be significantly prolonged in patients with extensive axonal degeneration. [orpha.net]

Treatment and prognosis Treatment focuses on symptom control. [radiopaedia.org]

Clinical features and prognosis with Guillain-Barré syndrome. Ann Indian Acad Neurol 2011; 14 : 98–99. [ PMC free article ] [ PubMed ] [ Google Scholar ] 6. Hiraga A, Mori M, Ogawara K, et al. [ncbi.nlm.nih.gov]

Out of seven, six cases were published after 2007. [10] It was found in the literature that the responsible organisms in etiology of concurrent GBS and ATM are mycoplasma, influenza, Bartonella henselae, and mumps. [atmph.org]

We discuss the possible role of serum effects in the etiology of GAN and speculate as to the molecular nature of the gan- defect. [rupress.org]

Etiology In the majority of cases, AMAN occurs following Campylobacter jejuni infection, in particular following infection with strains of C jejuni that cause enteritis. [orpha.net]

Etiology Mutations in both alleles of the giaxonin gene on chromosome 16 cause large accumulations of neurofilaments, axonal distention ("giant" axons), and degeneration of the myelin sheath 7. [radiopaedia.org]

To conclude, that authors have developed a new penetrant and specific test to diagnose GAN among a set of individuals exhibiting CMT2 of unknown etiology to suggest that the prevalence of GAN is probably under-evaluated among peripheral neuropathies. [institut-myologie.org]

Summary Epidemiology The overall annual incidence of GBS is estimated at between 1/91,000 and 1/55,000. [orpha.net]

Use at onset of corticosteroid Rx to prevent vascular occlusion Systemic connective tissue disorders & Vasculitis: Specific syndromes 4 Rheumatoid Arthritis Neuropathy: Vasculitic Epidemiology 10% of all RA 50% of RA with systemic vasculitis Longstanding [neuromuscular.wustl.edu]

Clinical and epidemiologic features of Guillain-Barré syndrome. J Infect Dis. 1997 Dec. 176 Suppl 2:S92-8. [Medline]. Walgaard C, Lingsma HF, Ruts L, Drenthen J, van Koningsveld R, Garssen MJ, et al. [medscape.com]

Benassi GD'Alessandro RGallassi RMorreale ALugaresi E Neurological examination in subjects over 65 years: an epidemiological survey. Neuroepidemiology. 1990;9:27-38. Google Scholar 36. [jamanetwork.com]

These cases we have reported show how axonal variants of GBS may masquerade as demyelinating pattern in initial nerve conduction studies and how do serial studies help in understanding the underlying pathophysiology. 1. [annalsofian.org]

It is possible that several different pathophysiological processes exist in AMAN to explain the dichotomous recovery patterns: reversible distal nerve failure at motor terminals or conduction block at nodes of Ranvier in association with rapid recovery [jnnp.bmj.com]

Sural nerve biopsy studies showed similarly increased basal lamina thickness of endoneurial vessels in patients with CIAP or patients with diabetic neuropathy when compared with controls, suggesting a similar pathophysiological mechanism ( 10 ). [care.diabetesjournals.org]

Because pathophysiology and symptoms are related, polyneuropathies are often classified by area of dysfunction: Myelin Vasa nervorum Axon Polyneuropathies may be acquired or inherited. [merckmanuals.com]

Back to Top Pathophysiology and Natural History Despite the diverse array of medical disorders that cause peripheral neuropathies, peripheral nerves exhibit only a few distinct pathologic reactions to an insult or disease: wallerian degeneration, axonal [clevelandclinicmeded.com]

Much of this research focuses on finding better ways to prevent, treat, and ultimately cure inherited neurological disorders such as GAN. [childneurologyfoundation.org]

Centers for Disease Control and Prevention. Available at . 2016 Feb 11; Accessed: 2016 Feb 12. Souayah N, Nasar A, Suri MF, Qureshi AI. [medscape.com]

Ann Indian Acad Neurol 2014;17:142-3 Sir, Guillain Barré syndrome (GBS) is a fairly common neurological disorder, which warrants immediate attention and management to prevent significant morbidity and mortality. [annalsofian.org]

Preventing CIPN Calcium and magnesium infusions have been shown to reduce the incidence of CIPN. [practicalpainmanagement.com]