Acute motor-sensory axonal neuropathy after cervical spine surgery

Journal of Neurosurgery. Spine
Massimo MiscusiVincenzo Petrozza

Abstract

The authors report the case of a 55-year-old man who presented with acute motor-sensory axonal neuropathy (AMSAN), a variant of Guillain-Barré syndrome with a poor prognosis, immediately after surgery for resection of a cervical chondroma. A misdiagnosis of spinal cord shock due to an acute surgical or vascular postoperative complication was initially made in this patient. Nevertheless, there was continuous transient improvement that was followed by progressive worsening, and further investigation was necessary. The diagnosis of AMSAN, associated with acute colitis caused by Helicobacter pylori, was made based on neurophysiological examinations and colonoscopy. Interestingly, the patient also developed nephrotic syndrome, which was thought to be a further complication of the autoimmune reaction. Delayed administration of immunoglobulins (400 mg/kg/day), mesalazine (800 mg 3×/day), and meropenem (3 g/day) was used to treat the Helicobacter infection and the autoimmune reaction, leading to restoration of renal function and slight neurological improvement. The patient's general condition and neurological status improved slightly, but he remained seriously disabled (Frankel Grade C). This case demonstrates that a new onset of neuro...Continue Reading

References

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Sep 20, 2011·Journal of Neurosurgery. Spine·Jocelyn ChengMichael Y Wang

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Citations

Aug 1, 2013·Expert Review of Clinical Immunology·Benjamin R Wakerley, Nobuhiro Yuki
Apr 7, 2016·Journal of Neuroimmunology·Bing YangRui-Sheng Duan
Feb 15, 2013·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·B R Wakerley, N Yuki
Sep 18, 2013·Helicobacter·Claire Roubaud BaudronAntonio Gasbarrini

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Methods Mentioned

BETA
chips
biopsies
biopsy

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