Nascent Potential: May It Be a Marker in Prediction of Malignant Course in Acute Motor Axonal Neuropathy?

Abstract

Acute motor axonal neuropathy (AMAN) is a subtype of Guillain-Barre syndrome (GBS) that is associated with a longer duration of illness and worse prognosis. Nonetheless, AMAN recovers well according to acute motor-sensory axonal neuropathy (AMSAN) that has been attributed to the underlying mechanisms such as terminal axonal damage as well as ganglioside antibody related injuries at nodes of Ranvier, rather than a primary axonopathy. On the other hand, in malignant coursed AMAN, ventral root degeneration has been shown to be the responsible mechanism for slow and incomplete recovery in these patients. In this report, I present a patient with malignant coursed AMAN who developed a rapidly, severe course of illness and no significant response to therapies (intravenous immunoglobulin and plasmapheresis) could be achieved even on the second month of follow-up. Via the presentation of this case, I draw attention to nascent potentials on electromyography as a potential paraclinical marker for malignant course in AMAN. Future studies investigating the utilizability of nascent potentials in determination of the prognosis of AMAN may provide vulnerable perspectives. In my opinion, these studies may also add crucial data for clarification of the unsolved pathophysiological mechanisms of AMAN.




J Neurol Res. 2017;7(1-2):16-18
doi: https://doi.org/10.14740/jnr418w