SHM Converge Scientific Abstract ePoster Gallery-Acute Motor Axonal Neuropathy Induced Neurogenic Shock After Covid-19

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This case report describes a 37-year-old man who developed Guillain-Barré syndrome (GBS) after a SARS-CoV-2 infection one month earlier. He presented after syncope with rapidly progressive inability to move his lower extremities. On exam, he was hypotensive and bradycardic, had complete motor paralysis (0/5 strength), preserved sensation, absent patellar reflexes, and decreased rectal tone. He required ICU admission for vasopressor support due to neurogenic shock and intubation for acute hypoxic respiratory failure.<br /><br />Diagnostic studies supported a motor variant of GBS. Lumbar puncture showed albuminocytologic dissociation with elevated myelin basic protein, consistent with inflammatory polyradiculoneuropathy. Electrophysiologic testing revealed acute motor axonal neuropathy (AMAN), a rare form of GBS that affects motor fibers while sparing sensory fibers. Nerve conduction studies showed normal sensory responses with absent motor responses, matching this pattern. MRI of the lumbar spine suggested possible cauda equina nerve root thickening/clumping, though the exam was limited. EEG showed diffuse slowing consistent with moderate-to-severe encephalopathy, without seizures.<br /><br />The patient received both intravenous immunoglobulin (IVIG) and plasmapheresis (PLEX), but despite treatment, he did not recover from the shock state. The report emphasizes that autonomic dysfunction can occur in GBS and, in rare cases such as this, progress to life-threatening neurogenic shock. The authors conclude that early recognition of ascending weakness, areflexia, respiratory failure, and dysautonomia is critical, and that outcomes depend on prompt treatment and coordinated care between neurology and intensive care teams.

Asset Subtitle

Loruanma Lam

Meta Tag

Author List Avni Agrawal, Christopher Marsalisi, Loruanma Lam, Pramod Reddy

Category Clinical Vignettes

Concept Guillain-Barré Syndrome

Concept AMAN Variant

Concept Autonomic Dysfunction

Concept Albuminocytologic Dissociation

Concept Nerve Conduction Studies

Distinguished Non-Finalist

Presenter Organization UF Jax Internal Medicine

Presenting Author Loruanma Lam

Track Adult

Keywords

Guillain-Barré syndrome

SARS-CoV-2 infection

acute motor axonal neuropathy

neurogenic shock

autonomic dysfunction

albuminocytologic dissociation

intravenous immunoglobulin

plasmapheresis

respiratory failure

areflexia

Guillain-Barré Syndrome

AMAN Variant

Autonomic Dysfunction

Albuminocytologic Dissociation

Nerve Conduction Studies