scholarly journals Development of Acute Inflammatory Demyelinating Polyneuropathy 11 Days after Spinal Surgery: A Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Eiichi Kakehi ◽  
Tadataka Kawakami ◽  
Yukiko Ishikawa ◽  
Takashi Matsuoka ◽  
Naoki Nakagawa ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Literature Review ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Spinal Surgery ◽  
Axonal Neuropathy ◽  
Immunoglobulin Therapy ◽  
Autonomic Nerve ◽  
Acute Motor Axonal Neuropathy ◽  
Study Results

Guillain–Barré syndrome (GBS) usually has a good prognosis; however, patients may develop sequelae without prompt treatment. We herein describe an 81-year-old woman who developed acute-onset excruciating thigh pain and weakness in her lower extremities after spinal surgery. We diagnosed acute inflammatory demyelinating polyradiculoneuropathy by a nerve conduction study, which showed findings of demyelination without cerebrospinal fluid analysis because of a spinal prosthesis. Although anti-GM1 and anti-GalNAc-GD1a antibodies were positive, the patient was clinically diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (a subtype of GBS), not acute motor axonal neuropathy. She recovered well with immunoglobulin therapy. A literature review of 18 cases revealed that unexplained weakness, areflexia, and numbness of the extremities after spinal surgery, a shorter time from spinal surgery to symptom onset to general GBS, abnormal nerve conduction study results, normal spinal imaging findings, and the development of atypical symptoms such as cranial and autonomic nerve syndrome and respiratory failure are useful for diagnosing GBS when cerebrospinal fluid examination cannot be performed after spinal surgery.

scholarly journals Electrophysiological patterns in patient with Guillain-Barre syndrome

2021 ◽  
Vol 12 (1) ◽  
pp. 16-21
Author(s):  
SM Monowar Hossain ◽  
Zahed Ali ◽  
Mohammad Motiur Rahman ◽  
Md Aolad Hossain ◽  
Pallab Kanti Saha ◽  
...  
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Axonal Neuropathy ◽  
Clinical Findings ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background: Guillain-Barre syndrome (GBS) is an acute, frequently severe and fulminant polyradiculoneuropathy that is autoimmune in nature. Incidence and predominant subtypes of GBS differ geographically. Electrophysiology has important role in subtyping GBS. This study aimed to evaluate the electrophysiological findings in patient of GBS. Methods: This was a hospital based cross-sectional descriptive study and conducted at the Department of Neurology in Sir Salimullah Medical College & Mitford Hospital, Dhaka and National Institute of Neurosciences and Hospital, Dhaka during July 2017 to June 2018. Clinically diagnosed 53 patients with GBS were enrolled according to prefixed selection criteria. Detail history taking, clinical examination, nerve conduction study and cerebrospinal fluid (CSF) examination was performed in all cases. Clinical findings, nerve conduction study (NCS) parameters, CSF findings and demographic profiles were evaluated. Results: Mean ± SD age of presentation was 41.64 (±14.56) years and median age was 42.0 years. There were total 33(62 %) males and 20 (38 %) females with male: female ratio of 1.7:1. Clinically two-thirds(62.3%) of patients had both upper and lower limb involvement (62.3%), facial weakness was in 32.1% and 13.2% had bulbar involvement. Acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN)were found to be 51%, 32% and 17% respectively. CSFprotein was elevated in most of the patients with a range of 16-725 mg/dl. Highest CSF protein was found in AIDP. Conclusion: Electrophysiological studies play an important role in the early detection; characterization of GBS.In this study, the commonest type of GBS was AIDP. Higher levels of CSF protein, absent H-reflex and Fresponse, sural sparing and unexcitable nerves are more frequently present in AIDP. BIRDEM Med J 2022; 12(1): 16-21

Fatal Acute Motor Axonal Neuropathy Induced by Nivolumab: A Case Report and Literature Review

2019 ◽  
Vol 17 (6) ◽  
pp. e1104-e1107 ◽  
Author(s):  
Nilgun Yildirim ◽  
Murat Gonen ◽  
Ferhat Balgetir ◽  
Muhammed Burak Er
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Axonal Neuropathy ◽  
Acute Motor Axonal Neuropathy

scholarly journals Case Report: Subacute onset of the motor-sensory axonal neuropathy variant of Gullain-Barré syndrome after epidural anesthesia

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1462
Author(s):  
Marie-Louise Kulas Søborg ◽  
Jacob Rosenberg ◽  
Jakob Burcharth
Keyword(s):  
Epidural Anesthesia ◽  
Peripheral Nerves ◽  
Spinal Surgery ◽  
Axonal Neuropathy ◽  
Sensory Neuropathy ◽  
Sensory Function ◽  
Demyelinating Neuropathy ◽  
Acute Motor Axonal Neuropathy ◽  
Rare Type ◽  
Accelerated Rehabilitation

Guillain-Barré syndrome (GBS) is an acute ascending peripheral neuropathy, caused by autoimmune damage of the peripheral nerves. GBS can be divided into three subtypes: acute inflammatory demyelinating neuropathy, acute motor axonal neuropathy, and the more rare type, acute motor and sensory axonal neuropathy (AMSAN). Reports of AMSAN with onset after epidural anesthesia and spinal surgery are extremely rare, and the linkage between development of GBS and neuroaxial anesthesia remains conclusively unconfirmed. We present a case in which the patient developed subacute motor and predominantly sensory neuropathy following epidural blockade. The case emphasizes the need of including AMSAN in differential diagnostic considerations to changes in motor and sensory function following epidural anesthesia, allowing accelerated rehabilitation and relevant alleviating therapy.

scholarly journals Pattern of Peripheral Neuropathy and B12 Assay among Type 2 Diabetic Saudi Patients

2020 ◽  
Vol 5 (11) ◽  
pp. 529-532
Author(s):  
Ahmed Abdulrahaman Ghalib ◽  
Jamil Ramadan ◽  
Bothaina Omar Marae
Keyword(s):  
Peripheral Neuropathy ◽  
Carpal Tunnel Syndrome ◽  
Glycemic Control ◽  
Vitamin B12 ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Axonal Neuropathy ◽  
Hypoglycemic Agents ◽  
Tunnel Syndrome

Objectives: to determine whether the pattern of peripheral neuropathy among Saudi types 2 diabetics has association with B12 status and glycemic control. Method: A cross section hospital based study. The pattern of diabetic neuropathy was determined by nerve conductive velocity (NCV) test, level of vitamin b12 was assayed among the study population and the glycemic control was determined according to Hba1c level. Results: A total of thirty three patients were enrolled in these study twenty one females and twelve males. The age ranged between 79 and 34 with the mean (SD) of 57 of these 17 (51.5%) used oral hypoglycemic agents and 16 (48.5%) were using insulin. HbAc1 more than 7 was found in 28 (84.8%) of the patients reflecting poor control. The nerve conduction study testing revealed that sensory axonal demyelination 6(18.2%), bilateral neuropathy 8 (24.2%), Right Carpal tunnel syndrome 5(15.2%), Left Carpal tunnel syndrome 0 (00%), mild axonal neuropathy 4 (12.1%) and 10 (30.3%) were found to have normal nerve conduction study test. The level of vitamin B12 was found 2(6%) was deficiency <180 pg/ml, 12(36.3%) possible deficiency 212 pg/ml-350 pg/ml and 19(57.5%) was >400 pg/ml. Conclusion: It could be concluded from this study that there is no association between pattern of peripheral neuropathy and B12 level in type II diabetics. Similarly no relation exists between Hb Ac1 level and pattern of peripheral neuropathy.

scholarly journals Chronic prurigo: Infrequent association with abnormal sural nerve conduction study results

2020 ◽  
Vol 1 (2) ◽  
pp. 93-94
Author(s):  
Rekha Virath ◽  
Asit Kumar Mittal ◽  
Tarun Kumar Ralot ◽  
Manisha Balai ◽  
Kapil Vyas
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Sural Nerve ◽  
Study Results

Nerve Conduction Study Results for Suspected Cubital Tunnel Syndrome

2020 ◽  
Vol 29 (4) ◽  
pp. e173
Author(s):  
Joost T.P. Kortlever ◽  
Berdien Brandsema ◽  
Meijuan Zhao ◽  
David C. Ring
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Study Results ◽  
Tunnel Syndrome

scholarly journals NERVE CONDUCTION STUDY IN DIFFERENT CLINICAL GRADES OF DIABETIC FOOT

2019 ◽  
pp. 61-63
Author(s):  
Hemchandra. V. Nerlekar ◽  
Shekhar gouda
Keyword(s):  
Nerve Conduction Study ◽  
Diabetic Foot ◽  
Nerve Conduction ◽  
Mixed Type ◽  
Sensory Nerve ◽  
Electrical Stimulus ◽  
Late Complications ◽  
Autonomic Nerve ◽  
Number Of Patients ◽  
The Difference

Background:Diabetic neuropathy is one of the commonest late complications of diabetes. Diabetic neuropathy can be either peripheral or autonomic. Nerve conduction study (NCS) is the recording and measurement of the compound nerve and muscle action potentials elicited in response to an electrical stimulus. Currently, the principal uses of NCV (Nerve Conduction velocity) study are to evaluate paresthesias (numbness, tingling, burning) and /or weakness of arms or legs. Methods: All patients diagnosed as diabetic foot were sent for Nerve Conduction Study after obtaining their written informed consent. Three nerves were studied; two motor nerves, Common peroneal and Tibial nerves, and one purely sensory nerve, Sural nerve. Results: Mixed type neuropathy with bilateral lower limb involvement was the most common type encountered. Interpretation and Conclusion: Mixed type of neuropathy was the most common in my study with respect to sensory and motor types of neuropathy; and also axonal and demyelinating types of neuropathy. Number of patients with bilateral neuropathy detected by NCV study in my study is more than that detected clinically and the difference is significant by applying the test of significance. Hence, NCV is a better study to detect nerve conduction abnormalities than clinical examination in diabetic foot.

Burkitt Lymphoma Presenting as a Paraneoplastic Demyelinating Disorder in a Child

2021 ◽  
Author(s):  
Arhanti Sadanand ◽  
Juhi Jain ◽  
Kathryn Elkins ◽  
Daniel John Bergsagel
Keyword(s):  
Cerebrospinal Fluid ◽  
Burkitt Lymphoma ◽  
Cranial Nerve ◽  
Axonal Neuropathy ◽  
Paraneoplastic Syndromes ◽  
Bilateral Ptosis ◽  
Acute Motor Axonal Neuropathy ◽  
Demyelinating Disorder ◽  
Neurologic Disorders ◽  
Cranial Nerve Palsies

AbstractIn adults, lymphomas have been associated with paraneoplastic syndromes that cause cranial nerve palsies, polyneuropathies, and paraplegias. These have been less frequently reported in children. We describe a pediatric patient who initially presented with palsy of her left third cranial nerve and bilateral ptosis. Initial diagnosis was concerning for myasthenia gravis, but after additional diagnostic evaluation, she was found to have acute motor axonal neuropathy. Cerebrospinal fluid studies were consistent with a diagnosis of Burkitt lymphoma. We discuss the importance of considering primary oncologic diagnoses in acute neurologic disorders with unusual presentations.

scholarly journals Clinical Outcome of Intravenous Immunoglobulin in the treatment of Guillain Barre Syndrome in a Nepalese Tertiary Centre

2019 ◽  
Vol 2 (1) ◽  
pp. 133-137
Author(s):  
Rajeev Ojha ◽  
Ragesh Karn
Keyword(s):  
Intravenous Immunoglobulin ◽  
Axonal Neuropathy ◽  
Immunoglobulin Therapy ◽  
University Teaching ◽  
Guillain Barre Syndrome ◽  
Disability Score ◽  
Acute Motor Axonal Neuropathy ◽  
Intravenous Immunoglobulin Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Intravenous Immunoglobulin is an approved therapy for Guillain Barre Syndrome. Our objective is to understand the management and outcome in Guillain Barre Syndrome patients treated with Immunoglobulin.Materials and Methods: All consecutive patients were retrospectively evaluated in the study were of age ≥16 years and were being admitted in the department of Neurology of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from 2016 March to 2017 February.Results: A total of 46 patients were included, mean age= 36.5±16.2 years, range = 16years to 80 years. Thirty-two patients (70%) were axonal variant, acute motor axonal neuropathy is more common (18 patients). Intravenous immunoglobulin was used in 23 patients (50%), 17 of them were axonal variant and 6 were demyelinating. Guillain Barre Syndrome patients with bilateral facial weakness (70% vs 30%; p<0.05) were likely to receive immunoglobulin therapy. Patients with immunoglobulin were found to have higher ODSS at Nadir (9.3±1.8 vs 6.9±1.9; p <0.001) and discharge than patients without immunoglobulin treatment (6.2±1.7 vs 5.0±1.6; p=0.001). At Nadir, Patients with immunoglobulin were found to have higher Guillain Barre Syndrome disability score (4.1±0.7 vs 3.2±0.9; p<0.095). In immunoglobulin group, Axonal variants were found to havehigher ODSS score (9.6±1.9 vs 8.2±0.9, p=0.027) and Guillain Barre Syndrome disability score (4.2±0.7 vs 3.5±0.5; p=0.019) at nadir than demyelinating group.Conclusions: Intravenous Immunoglobulin is easier to administer and is safe with fewer adverse effects. Although expensive, it is an effective treatment option in a resource-limited center. Axonal variants are clinically severe and likely to be need of Intravenous Immunoglobulin therapy.

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