Acute motor conduction block neuropathy Another Guillain–Barré syndrome variant

Capasso, Margherita; Caporale, Christina M.; Pomilio, F.; Gandolfi, P; Lugaresi, Alessandra; Uncini, Antonino

doi:10.1212/wnl.61.5.617

Cited by 128 publications

(117 citation statements)

References 38 publications

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“…[18][19][20][21] In the current study, we found significant associations of reversible conduction failure with IgG anti-GM1, -GalNAc-GD1a, -GD1b, and -LM1/GA1 antibodies. Reversible conduction failure was first described in 1998 and this was followed by reports of similar findings in other cohorts.…”

Section: Resultssupporting

confidence: 59%

Antibodies to single glycolipids and glycolipid complexes in Guillain-Barré syndrome subtypes

et al. 2014

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Objective: To comprehensively investigate the relationship between antibodies to single glycolipids and their complexes and Guillain-Barré syndrome subtypes and clinical features.Methods: In acute sera from 199 patients with Guillain-Barré syndrome, immunoglobulin G (IgG) antibodies to glycolipids and ganglioside complexes were tested using ELISA against individual antigens from single glycolipids including gangliosides (LM1, GM1, GM1b, GD1a, GalNAc-GD1a, GD1b, GT1a, GT1b, GQ1b) and a neutral glycolipid, asialo-GM1 (GA1), and antigens from the combination of 2 different glycolipids. Based on serial nerve conduction studies, the electrodiagnoses were as follows: 69 demyelinating subtype, 85 axonal subtypes, and 45 unclassified.Results: Significant associations were detected between acute motor axonal neuropathy subtype and IgG antibodies to GM1, GalNAc-GD1a, GA1, or LM1/GA1 complex. Reversible conduction failure was significantly associated with IgG antibodies to GM1, GalNAc-GD1a, GD1b, or complex of LM1/GA1. No significant association was demonstrated between acute inflammatory demyelinating polyneuropathy and any of the glycolipids or ganglioside complexes. Antiganglioside complex antibodies alone were detected in 7 patients (5 axonal subtype). Conclusions:The current study demonstrates that antibodies to single glycolipids and ganglioside complexes are associated with acute motor axonal neuropathy or acute motor conduction block neuropathy but not acute inflammatory demyelinating polyneuropathy. Classification of evidence:This study provides Class II evidence that antibodies to glycolipids are increased in patients with acute motor axonal neuropathy and acute motor conduction block neuropathy but not acute inflammatory demyelinating polyneuropathy. Neurology ® 2014;83:118-124 GLOSSARY AIDP 5 acute inflammatory demyelinating polyneuropathy; AMAN 5 acute motor axonal neuropathy; AMCBN 5 acute motor conduction block neuropathy; GBS 5 Guillain-Barré syndrome; GSC 5 ganglioside complex; Ig 5 immunoglobulin; NCS 5 nerve conduction study.Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy with 2 major subtypes: acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN).1 Within the axonal subtype, there are now recognized variants evident on nerve conduction studies (NCS), which demonstrate early reversible conduction failure, referred to as acute motor conduction block neuropathy (AMCBN).2 There is robust evidence that immunoglobulin G (IgG) anti-ganglioside antibodies are associated with the pathogenesis of AMAN, whereas the target antigens in AIDP remain elusive. The patients who were seronegative for antibodies to single gangliosides were found to have anti-GSC antibodies. The authors have since described further associations between anti-GSC antibodies and variants of GBS. This includes antibodies to LM1 and its complexes in AIDP, 5 to complex of GM1 and GalNAc-GD1a (GM1/GalNAc-GD1a) in AMCBN,6 and to complexes of GD1a/GD1b and GD1b/GT1b in pa...

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Section: Resultssupporting

confidence: 59%

Antibodies to single glycolipids and glycolipid complexes in Guillain-Barré syndrome subtypes

et al. 2014

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“…Although hyporeflexia or areflexia is the hallmark of GBS, normal reflexes or hyperreflexia is not a finding inconsistent with the diagnosis of GBS. The variants most commonly reported to be associated with retained or brisk reflexes are AMAN, acute motor conduction block neuropathy, and acute facial diplegia with brisk reflexes 8,9 . The incidence of hyperreflexia in AMAN is reported to be between 33% and 48% 1,2 .…”

Section: Discussionmentioning

confidence: 99%

“…Preserved reflexes and even hyperreflexia may occur in patients with pure motor GBS and are not inconsistent with the diagnosis. It is more appropriate to classify this neuropathy as a GBS variant, which Capasso et al, suggest calling "acute motor conduction block neuropathy," emphasizing the presence of conduction blocks and avoiding the pathophysiologic implication that all conduction blocks are demyelinating in nature 9 .…”

Section: Discussionmentioning

confidence: 99%

Hyperreflexic Guillain - Barre Syndrome: A Rare Case Report and a Brief Review of Literature

Mogal¹,

Sanap²,

Patil³

et al. 2015

jmscr

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“…Acute motor conduction block neuropathy presents with symmetric proximal and distal weakness without sensory abnormalities with normal or even brisk reflexes following C. Jejuni enteritis. Elevated IgG antibody titers to GD1a and GM1 have been reported and electrophysiology showed normal sensory conductions and partial motor conduction block in intermediate and distal nerve segments that resolves within 2 to 5 weeks [28].…”

Section: Gbs Variantsmentioning

confidence: 99%

Guillain-Barré Syndrome

Dimachkie

Barohn

2013

Curr Treat Options Neurol

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Acute motor conduction block neuropathy Another Guillain–Barré syndrome variant

Abstract: Acute motor neuropathy with normal or brisk tendon reflexes, conduction block, and fast recovery appears to be a variant of Guillain-Barré syndrome. Conduction block may result from immune-mediated conduction failure at the nodes of Ranvier without demyelination.

Cited by 128 publications

References 38 publications

Antibodies to single glycolipids and glycolipid complexes in Guillain-Barré syndrome subtypes

Antibodies to single glycolipids and glycolipid complexes in Guillain-Barré syndrome subtypes

Hyperreflexic Guillain - Barre Syndrome: A Rare Case Report and a Brief Review of Literature

Guillain-Barré Syndrome

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