Hyperacute Guillain-Barré Syndrome Reaching Clinical Nadir Within 16 Hours

Area of Science:

• Neurology
• Neuroimmunology

Background:

• Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting peripheral nerves.
• Acute motor axonal neuropathy (AMAN) is a GBS variant characterized by motor nerve damage.
• Hyperacute progression to nadir within 24 hours is uncommon but possible in GBS variants.

Purpose of the Study:

• To report a case of AMAN with rapid progression.
• To highlight diagnostic challenges and treatment outcomes in a rare GBS variant.
• To emphasize the importance of considering GBS in hyperacute neurological presentations.

Main Methods:

• Clinical presentation of a 36-year-old male with rapid lower-limb weakness.
• Initial and follow-up nerve conduction studies (NCS).
• Laboratory testing for anti-GM1 antibodies and treatment with intravenous immunoglobulin (IVIg).

Main Results:

• Initial NCS showed minimal abnormalities (decreased F-waves); follow-up revealed axonal damage.
• Patient tested positive for immunoglobulin G-class anti-GM1 antibodies.
• IVIg therapy resulted in gradual improvement of muscle strength.

Conclusions:

• The case illustrates AMAN, a GBS variant, presenting with hyperacute progression.
• Early recognition and treatment with IVIg are crucial for favorable outcomes in AMAN.
• Consideration of GBS is vital even with rapid symptom onset and initial non-specific NCS findings.