Department of Neurology, Konkuk University School of Medicine, Chungju, Korea.
J Korean Med Sci. 2013 Dec;28(12):1839-41. doi: 10.3346/jkms.2013.28.12.1839. Epub 2013 Nov 26.
Acute motor and sensory axonal neuropathy (AMSAN) are recently described subtypes of Guillain-Barre syndrome characterized by acute onset of distal weakness, loss of deep tendon reflexes, and sensory symptoms. A 21-yr-old male was transferred to our hospital due to respiration difficulties and progressive weakness. In laboratory findings, immunoglobulin M antibodies against hepatitis A were detected in blood and cerebrospinal fluid. The findings of motor nerve conduction studies showed markedly reduced amplitudes of compound muscle action potentials in bilateral peroneal, and posterior tibial nerves, without evidence of demyelination. Based on clinical features, laboratory findings, and electrophysiologic investigation, the patient was diagnosed the AMSAN following acute hepatitis A viral infection. The patient was treated with intravenous immunoglobulin and recovered slowly. Clinicians should consider this rare but a serious case of AMSAN following acute hepatitis A infection.
急性运动感觉轴索性神经病(AMSAN)是吉兰-巴雷综合征的新近描述的亚型,其特征为急性发作的远端肌无力、深腱反射消失和感觉症状。一名 21 岁男性因呼吸困难和进行性无力被转至我院。实验室检查发现,患者血液和脑脊液中存在针对甲型肝炎的免疫球蛋白 M 抗体。运动神经传导研究的结果显示,双侧腓总神经和胫后神经的复合肌肉动作电位幅度明显降低,无脱髓鞘证据。根据临床特征、实验室检查和电生理研究,该患者被诊断为急性甲型肝炎病毒感染后 AMSAN。患者接受了静脉注射免疫球蛋白治疗,恢复缓慢。临床医生应考虑这种罕见但严重的急性甲型肝炎感染后 AMSAN 病例。