Join us   Log in   editor@jmedicalcasereports.org  

Abstract


FRONTIERS IN MEDICAL CASE REPORTS - Volume 3; Issue 3, (May-Jun, 2022)

Pages: 1-07

Guillain–Barré Syndrome with MFS and AMSAN Variants: A Rare Case

Afnan. W. M. Jobran, Ranin F. F. Alawi, Majd A. AbuAlrob, Anis Munir Naser

Category: Medical Case Reports

Download PDF

Abstract:

Background: The immunologically mediated polyneuropathies Guillain–Barré syndrome (GBS) and Guillain–Barré syndrome (GBS) are important clinically. It is assumed to have a hereditary component, although no genetic risk locus has been identified. It's thought to be autoimmune, but the causes are unknown. It might be generated by molecular mimicry, such as from pathogens and vaccines, but hosting factor and co-founding host reactions would undoubtedly alter disease incidence and course. Case Presentation: A 57 year old female, three weeks after influenza vaccination she started complaining of double vision, left eye ptosis, dizziness, and bilateral symmetric upper and lower extremities weakness which described as “feeling sleepy”, both proximal and distal muscles are equally affected. The patient sought medical advice, ophthalmology examination and radiological imaging were free. Conclusion: AMSAN is recently identified GBS variant characterized by sensory symptoms, loss of deep tendon reflexes, and distant weakness with immediate onset.

Keywords: Guillain–Barré, Immune Response, Axonal Neuropathy, Polyradiculoneuropathy

References:

Anthony SA, Thurtell MJ, Leigh RJ. Miller Fisher syndrome mimicking ocular myasthenia gravis. Optom Vis Sci 2012; 89: e118-e123.

Asbury AK and Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol 1990; 27: S21-S24.

Asbury AK. Criteria for diagnosis of Guillain-Barré syndrome. Ann Neurol 1978; 3: 565-566.

Bukhari S and Taboada J. A case of Miller Fisher syndrome and literature review. Cureus 2017; 9: e1048.

Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Ganglioside composition of the human cranial nerves, with special reference to pathophysiology of Miller Fisher syndrome. Brain Res 1997; 745: 32-36.

Chowdhury D and Arora A. Axonal Guillain–Barré syndrome: a critical review. Acta Neurol Scand 2001; 103: 267-277.

Feasby TE, Gilbert JJ, Brown WF, Bolton CF, Hahn AF, Koopman WF, Zochodne DW. An acute axonal form of guillain-barrée polyneuropathy. Brain 1986; 109: 1115-1126.

Gupta SK, Jha KK, Chalati MD, Alashi LT. Miller Fisher syndrome. BMJ Case Rep 2016; 2016: bcr2016217085.

Hadden RD, Cornblath DR, Hughes RA, Zielasek J, Hartung HP, Toyka KV, Swan AV, Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Ann Neurol 1998; 44: 780-788.

Jacobs BC, Endtz HP, van der Meché FG, Hazenberg MP, Achtereekte HA, van Doorn PA. Serum anti-GQ1b IgG antibodies recognize surface epitopes on Campylobacter jejuni from patients with Miller Fisher syndrome. Ann Neurol 1995; 37: 260-264.

Jacobs BC, van Doorn PA, Tio-Gillen AP, Visser LH, van der Meché FG, Schmitz PI, Herbrink P, Hooijkaas H. Campylobacter jejuni infections and anti-GM1 antibodies in Guillain-Barré syndrome. Ann Neurol 1996; 40: 181-187.

Kuijf M, Ruts L, van Doorn PA, Koudstaal PJ, Jacobs BC. Diagnostic value of anti-GQ1b antibodies in a patient with relapsing dysarthria and ataxia. BMJ Case Rep 2009; 2009: bcr0820080783.

Kuwabara S, Ogawara K, Mizobuchi K, Koga M, Mori M, Hattori T, Yuki N. Isolated absence of F waves and proximal axonal dysfunction in Guillain-Barre syndrome with antiganglioside antibodies. J Neurol Neurosurg Psychiatry 2000; 68: 191-195.

Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T. Clinical features and prognosis of Miller Fisher syndrome. Neurology 2001; 56: 1104-1106.

Overell JR and Willison HJ. Recent developments in Miller Fisher syndrome and related disorders. Curr Opin Neurol 2005; 18: 562-566.

Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis. Neuroepidemiology 2011; 36: 123-133.

Sejvar JJ, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter R, Burwen DR, Cornblath DR, Cleerbout J, Edwards KM, Heininger U. Guillain-Barré syndrome and Fisher syndrome: Case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2011; 29: 599-612.

Visser LH, Van der Meché FG, Van Doorn PA, Meulstee J, Jacobs BC, Oomes PG, Kleyweg RP. Guillain-Barré syndrome without sensory loss (acute motor neuropathy) A subgroup with specific clinical, electrodiagnostic and laboratory features. Brain 1995; 118: 841-847.

Vucic S, Kiernan MC, Cornblath DR. Guillain-Barré syndrome: an update. J Clin Neurosci 2009; 16: 733-741.

Yepishin IV, Allison RZ, Kaminskas DA, Zagorski NM, Liow KK. Miller Fisher syndrome: a case report highlighting heterogeneity of clinical features and focused differential diagnosis. Hawaii J Med Public Health 2016; 75: 196-199.

Yuki N, Kuwabara S, Koga M, Hirata K. Acute motor axonal neuropathy and acute motor-sensory axonal neuropathy share a common immunological profile. J Neurol Sci 1999; 168: 121-126.

Yuki N. Infectious origins of, and molecular mimicry in, Guillain-Barré and Fisher syndromes. Lancet Infect Dis 2001; 1: 29-37.

Yuki N. Molecular mimicry between gangliosides and lipopolysaccharides of Campylobacter jejuni isolated from patients with Guillain-Barré syndrome and Miller Fisher syndrome. J Infect Dis 1997; 176: S150-S153.

DOI URL: http://dx.doi.org/10.47746/FMCR.2022.3305