AMAN, Acute motor axonal neuropathy entities
Clinic
- Acute motor axonal neuropathy (AMAN) is a pure motor axonal subtype of Guillain-Barré syndrome
- AMAN progresses more rapidly and has an earlier peak than GBs
- Tendon reflexes are relatively preserved or even exaggerated
- Autonomic dysfunction is rare
- Autoantibodies that bind to GM1 or GD1a gangliosides at the nodes of Ranvier activate complement and disrupt sodium-channel clusters and axoglial junctions, which leads to nerve conduction failure and muscle weakness.
Sign/ Symptoms
AMAN is characterized by acute progressive
- Motor weakness
- Areflexia??? Hyper reflexia
- Ataxia
- Oculomotor dysfunction
- Absence of sensory symptoms
AMAN is typically preceded by an infection from bacteria called Campylobacter jejuni or Haemophilus influenzae. [1]
Causes
A link to Campylobacter jejuni was suspected when a young girl was admitted to Second Teaching Hospital. She had become ill after feeding the family chickens. She developed acute paralysis and respiratory failure. Investigators discovered that several of the chickens in the home displayed similar symptoms and C. jejuni was found in their droppings. Several of the paralysis patients were found to have antibodies to C. jejuni and anti-GD1a antibodies, suggesting a link between the pathogen and the disease. In 2015, Zika virus was linked to AMAN.
Miasms
SHBV is the best miasm because of Ataxia, GBS and Diplopia.
Note:
Hyporeflexia is not a complete rubric