Maqbool Muhammad, Deekshitha Kuchi, Chandana Doddapaneni D, Abbas Zaghum, Talukdar Ananya, Mehdi Asma
Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PAK.
Internal Medicine, Sri Venkateswara Medical College, Tirupati, IND.
Cureus. 2024 Oct 3;16(10):e70787. doi: 10.7759/cureus.70787. eCollection 2024 Oct.
This case report presents a rare instance of acute motor axonal neuropathy (AMAN), a subtype of Guillain-Barré syndrome (GBS), in a 25-year-old postpartum female. The patient experienced a seven-day history of progressive, ascending motor weakness in all four limbs, beginning shortly before delivery and rapidly worsening postpartum. Notably, she exhibited no sensory deficits, a hallmark feature of AMAN, which was confirmed by nerve conduction studies revealing significant motor axonal involvement with preserved sensory function. The diagnostic process was complicated by the overlap of AMAN symptoms with other neurological conditions and the unusual postpartum context. Treatment with high-dose corticosteroids and plasmapheresis resulted in significant clinical improvement, underscoring the effectiveness of these interventions in managing AMAN. This case highlights the importance of considering AMAN in postpartum patients presenting with acute motor deficits, even in the absence of typical GBS sensory symptoms. It also emphasizes the need for early diagnosis and a multidisciplinary approach to optimize patient outcomes. By contributing to the limited literature on AMAN in postpartum women, this report aims to enhance clinical awareness, improve diagnostic accuracy, and inform treatment strategies for similar cases in the future.
本病例报告呈现了一例罕见的急性运动轴索性神经病(AMAN),这是格林-巴利综合征(GBS)的一种亚型,发生在一名25岁的产后女性身上。患者有四肢进行性、上行性运动无力的病史,持续七天,始于分娩前不久并在产后迅速恶化。值得注意的是,她没有感觉障碍,这是AMAN的一个标志性特征,神经传导研究证实存在明显的运动轴索受累而感觉功能保留,从而得以确诊。AMAN症状与其他神经系统疾病的重叠以及产后这一特殊背景使诊断过程变得复杂。大剂量皮质类固醇和血浆置换治疗带来了显著的临床改善,突出了这些干预措施在治疗AMAN方面的有效性。本病例强调了在出现急性运动功能缺损的产后患者中考虑AMAN的重要性,即使没有典型的GBS感觉症状。它还强调了早期诊断和多学科方法以优化患者预后的必要性。通过为产后女性AMAN的有限文献做出贡献,本报告旨在提高临床认识、改善诊断准确性,并为未来类似病例的治疗策略提供参考。