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

Tosun, Ayşe; Dursun, Şiar; Akyıldız, Utku Oğan; Oktay, Selin Akyüz; Tataroglu, Cengiz

doi:10.1177/0883073814528377

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…Twenty-seven out of 45 (60 %) patients showed an axonal pattern that in 25 patients was restricted to motor fibres (the AMAN pattern) and in 2 involved motor and sensory fibres (the acute motor and sensory axonal neuropathypattern) 15 16. In five patients, all with antiganglioside antibodies, reversible conduction failure was demonstrated at follow-up studies.…”

Section: Resultsmentioning

confidence: 99%

Hyper-reflexia in Guillain-Barré syndrome: systematic review

Uncini

Notturno

Kuwabara

2020

J Neurol Neurosurg Psychiatry

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Areflexia or hyporeflexia is a mandatory clinical criterion for the diagnosis of Guillain-Barré syndrome (GBS). A systematic review of the literature from 1 January 1993 to 30 August 2019 revealed 44 sufficiently detailed patients with GBS and hyper-reflexia, along with one we describe. 73.3% of patients were from Japan, 6.7% from the USA, 6.7% from India, 4.4% from Italy, 4.4% from Turkey, 2.2% from Switzerland and 2.2% from Slovenia, suggesting a considerable geographical variation. Hyper-reflexia was more frequently associated with antecedent diarrhoea (56%) than upper respiratory tract infection (22.2%) and the electrodiagnosis of acute motor axonal neuropathy (56%) than acute inflammatory demyelinating polyneuropathy (4.4%). Antiganglioside antibodies were positive in 89.7% of patients. Hyper-reflexia was generalised in 90.7% of patients and associated with reflex spread in half; it was present from the early progressive phase in 86.7% and disappeared in a few weeks or persisted until 18 months. Ankle clonus or Babinski signs were rarely reported (6.7%); spasticity never developed. 53.3% of patients could walk unaided at nadir, none needed mechanical ventilation or died. 92.9% of patients with limb weakness were able to walk unaided within 6 months. Electrophysiological studies showed high soleus maximal H-reflex amplitude to maximal compound muscle action potential amplitude ratio, suggestive of spinal motoneuron hyperexcitability, and increased central conduction time, suggestive of corticospinal tract involvement, although a structural damage was never demonstrated by MRI. Hyper-reflexia is not inconsistent with the GBS diagnosis and should not delay treatment. All GBS variants and subtypes can present with hyper-reflexia, and this eventuality should be mentioned in future diagnostic criteria for GBS.

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Section: Resultsmentioning

confidence: 99%

Hyper-reflexia in Guillain-Barré syndrome: systematic review

Uncini

Notturno

Kuwabara

2020

J Neurol Neurosurg Psychiatry

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“…Recently, there have been several descriptions of reflex preservation and hyperreflexia in axonal GBS. [ 4 5 6 ] Hyperreflexia developed during the early phase of recovery of AMAN form. In the literature, moreover, 48% of Chinese and 33% of Japanese patients with GBS showed hyperreflexia.…”

Section: Discussionmentioning

confidence: 99%

“…Tosun et al . [ 5 ] reported a 12-year-old girl with hyperactive deep tendon reflexes with AMSAN form without GD1a-antibody. The authors could not explain the condition in the patient.…”

Section: Discussionmentioning

confidence: 99%

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Guillain–Barré syndrome with hyperreflexia and bilateral papillitis in a child

et al. 2016

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Guillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy characterized by rapidly progressive symmetric weakness, and areflexia. Areflexia is necessary for the diagnosis of GBS. However, recently there have been studies of hyperreflexia with axonal neuropathy form of GBS. We report a 14-year-old boy with GBS, who presented with hyperreflexia and bilateral papillitis. To the best of our knowledge, this is the first pediatric patient presenting with papillitis and hyperreflexia with acute motor and sensory axonal neuropathy form of GBS.

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“…The authors recall the fact that M pneumonia can be the trigger for large peripheral and central neurological manifestations, through several sorts of pathomechanisms, making it more difficult to identify the correct diagnosis. [28][29][30][31] Second, neurological symptoms were misleading because of the association between central and peripheral involvement disorders: involvement of cranial nerves, tetraparesia that was predominant on the upper limb, 32 and deep tendon reflexes first noted as normal, then brisk, [33][34][35] and finally depressed.…”

Section: Discussionmentioning

confidence: 99%

A New Observation of an Atypical and Severe Variant of the Guillain-Barre Syndrome in a Child

Pons

Manel

Ville

et al. 2015

Child Neurology Open

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Guillain-Barré syndrome is a rare acute polyradiculoneuropathy. Several variants and unusual presentations have been described, particularly in pediatrics. In most cases, making an early diagnosis is challenging due to the treatments that consist in the rapid administration of intravenous immunoglobulin or plasma exchange. The authors present the case of a 7-year-old boy with an atypical and severe axonal Guillain-Barré syndrome, associated with Mycoplasma pneumonia. When he was admitted, febrile respiratory failure was the main focus, and then he presented signs of acute polyneuropathy with cranial nerve palsy and brief hyperreflexia. Mechanical ventilation was required for 48 days as well as 2 cycles of intravenous immunoglobulin. The authors describe all the medical challenges that the authors encountered. This case highlights the fact that respiratory distress can be the main clinical symptom in children. This delays the establishment of a correct diagnosis, even more so when neurological manifestations are abundant and unusual.

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

Cited by 4 publications

References 15 publications

Hyper-reflexia in Guillain-Barré syndrome: systematic review

Hyper-reflexia in Guillain-Barré syndrome: systematic review

Guillain–Barré syndrome with hyperreflexia and bilateral papillitis in a child

A New Observation of an Atypical and Severe Variant of the Guillain-Barre Syndrome in a Child

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