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Acute motor axonal neuropathy with hyperreflexia and central demyelination associated to anti-GA1 antibodies

L.M. Murillo-Bonilla, C. Méndez-González, B. Álvarez, C. Ramírez [REV NEUROL 2011;52:283-288] PMID: 21341223 DOI: https://doi.org/10.33588/rn.5205.2010605

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Volumen 52 | Number 05 | Nº of views of the article 16.327 | Nº of PDF downloads 984 | Article publication date 01/03/2011

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ABSTRACT

CASE REPORT We report the case of a 37-year-old male who presented signs of acute motor axonal polyradiculoneuropathy that began three weeks after a three-day bout of gastroenteritis and was accompanied by a stiff neck, hyperreflexia and anti-GA1 antibodies. The symptoms developed within 12 hours, after beginning with the patient waking up in the middle of the night with a headache; the following morning he presented general weakness and cranial neuropathy and therefore decided to go to hospital. The neurological examination showed multiple cranial neuropathy, quadriparesis with hyperreflexia, bilateral Babinski and a stiff neck. Following treatment, first with methylprednisolone and then with gamma globulin, the development of the illness was halted. Neuroinfection due to lumbar puncture was ruled out and acute motor axonal polyradiculoneuropathy was confirmed in a second neuroconduction study performed seven days after admission. Magnetic resonance imaging revealed an area of demyelination in the white matter and the presence of anti-GA1 antibodies was detected in the serological analysis. Two years later, the patient performs activities of daily living, walks with assistance and has gone back to work.

CONCLUSIONS Acute motor axonal polyradiculoneuropathy with hyperreflexia, a stiff neck and central demyelination can be associated to anti-GA1 antibodies. Treatment with gamma globulin appears to curb development of the disease. KeywordsAcute motor axonal neuropathy Antiganglioside antibodies Gangliosidoses Guillain-Barre syndrome Hyperreflexia Polyradiculoneuropathy CategoriesNervios periféricos, unión neuromuscular y músculo

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Nota Clínica

Acute motor axonal neuropathy with hyperreflexia and central demyelination associated to anti-GA1 antibodies