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53 years old, female
53 years old, female
Past medical history included hypothyroidism and dyslipidemia, and was treated with levothyroxine and rosuvastatin accordingly
Hypothyroidism and dyslipidemia, and treat accordingly with levothyroxine and rosuvastatin
Physical examination revealed normal muscle strength, sensation, deep tendon reflexes, and coordination in the upper and left leg
Emergency head CT and CTA did not reveal early ischemic changes or arterial occlusion
normal sinus rhythm normal sinus rhythm
Over the next 24 hours, the patient rapidly developed quadriplegia and dysphagia
Tracheal intubation and transfer to the intensive care unit Cardiology team was unable to determine a specific cause or trigger for ventricular fibrillation, including no apparent electrolyte imbalance, toxic exposure, or structural cardiac abnormalities
After stopping the anesthesia, he still couldn't get off the ventilator, and there was no cough and gag reflex
Lumbar puncture revealed elevated protein (0.
surface
Treatment with intravenous immunoglobulin (IVIG) 2 g/kg for 5 days was unresponsive
discuss:
discuss:GBS is a demyelinating immune-mediated polyneuropathy that is an important cause of acquired neuromuscular weakness
Pathophysiology is mediated by molecular mimicry, with various anti-ganglioside antibodies found in patient serum, the most common being anti-GM1, anti-GD1a, and anti-GD1b
Electrophysiological testing plays a key role in the diagnosis of AMAN, as it does in AIDP
Autonomic dysfunction in GBS patients has various manifestations, the most common being sinus arrhythmia, blood pressure instability, urinary retention, pupillary abnormalities, and sudomotor dysfunction
Sinus arrhythmia, blood pressure instability, urinary retention, pupillary abnormalities, and sweating dysfunction Autonomic dysfunction , arrhythmias with ventricular tachycardia, atrial fibrillation with rapid ventricular response, neurogenic myocardial stunning, cardiomyopathy, syndrome of inappropriate antidiuretic hormone secretion, and posterior reversible encephalopathy syndrome are less common
This case of AMAN has certain educational significance for clinicians
Another learning point is the manifestation of autonomic involvement
In terms of treatment, numerous clinical trials have demonstrated that IVIG and plasma exchange are effective for AIDP
Original source:
Original source:Pearls & Oy-sters: Delayed Diagnosis of Acute Motor Axonal Neuropathy With Cardiac Arrest .
Neurology.
2022 Feb 22;98(8):336-339.
doi: 10.
1212/WNL.
0000000000013220.
Epub 2021 Dec 14.
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