Acute Motor Axonal Neuropathies: Incidence, Evolution and Outcomes at the University Hospital of Seville (P06.148)

Abstract

Objective: To analyze the epidemiological, clinical presentation and outcomes of the axonal variant of Guillain-Barre syndrome in a tertiary university hospital in Seville, Spain. Background Guillain-Barre Syndrome (GBS) is the most common cause of generalized acute polyradiculoneuropathy worldwide. Acute motor axonal neuropathy (AMAN) is most common in China and Japan, but has been documented in Europe as well. Design/Methods: We analyzed 73 cases of patients discharged from the Neurology department between 2006-2011 with the diagnosis of GBS. Detailed clinical presentation, electrophysiological pattern, serologic, and microbiologic data were obtained with a follow-up of 6 months. We obtained 11 cases of AMAN. Results: In our series, AMAN affected 7 females and 4 males. The mean age of presentation was 60 years old (range 42-75). We did not find any seasonal preferences. Three of our patients had diarrhea prior to the onset of the disease although C. Jejuni antibodies were negative in all of them. Five of our patients (45.5%) required respiratory support and admission to the UCI. Three of our patients (27.2%) had GM-1 positive antibodies while 8 (72.7%) cases were negative. CSF was abnormal in 45.5% cases. Electrophysiological studies showed that all patients had an axonal variant of GBS. All patients were treated with IVIG and 4 had PEX in addition to IVIG. Mortality rate was (18%). All of our patients required physical therapy and continued to have residual symptoms at the follow up visit. Conclusions: Although AMAN is more commonly diagnosed in China and Japan, we observed a similar phenotype in our population group including severe residual disability and high mortality. Disclosure: Dr. Martinez-Agredano has nothing to disclose. Dr. Montes-Latorre has nothing to disclose. Dr. Ruiz-Rodriguez has nothing to disclose. Dr. Jimenez has nothing to disclose.