title: Hyperreflexia in axonal Guillain-Barré syndrome subsequent to Campylobacter jejuni enteritis.
abstract: We describe a patient with the acute motor axonal neuropathy (AMAN) form of Guillain-Barré syndrome (GBS), who showed generalized hyperreflexia. A 24-year-old man developed acute paralysis following Campylobacter jejuni enteritis. He showed exaggerated tendon reflexes with abnormal reflex spread to other segments, and was initially diagnosed as having post-infectious myelitis. Nerve conduction studies showed motor axonal degeneration (the AMAN pattern), and increased soleus H-reflex amplitudes. His serum was positive for IgG antibodies to gangliosides GM1b and GalNAc-GD1a. He was treated with plasmapheresis, resulting in rapid recovery. Hyperreflexia was still present 12 months after onset when muscle strength was completely normal. This case provides further evidence that patients with AMAN can develop increased motor neuron excitability, and possible mechanisms for the hyperreflexia are discussed.
authors.affiliation: Department of Neurology, Chiba University School of Medicine, 1-8-1 Inohana, Chuo, Chiba 260-8670, Japan. kuwabara@med.m.chiba-u.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Miho
authors.initials: M
authors.lastname: Nakata
authors.forename: Jia-Ying
authors.initials: JY
authors.lastname: Sung
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mori
authors.forename: Naoko
authors.initials: N
authors.lastname: Kato
authors.forename: Takamichi
authors.initials: T
authors.lastname: Hattori
authors.forename: Michiaki
authors.initials: M
authors.lastname: Koga
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D002169:Campylobacter Infections / Q000150:complications* / Q000276:immunology; D016123:Campylobacter jejuni / Q000276:immunology; D004568:Electrodiagnosis; D004751:Enteritis / Q000150:complications* / Q000276:immunology; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D006181:H-Reflex; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D009431:Neural Conduction; D010956:Plasmapheresis; D012021:Reflex, Abnormal
chemical_list: D000907:Antibodies, Bacterial; D005732:Gangliosides; D007074:Immunoglobulin G