Acute Motor Axonal Neuropathy (AMAN), a Variant of Guillain-Barre Syndrome: A Case Study: Difference between revisions

(Created page with "Abstract This case study documents a fictional description of a patient presenting with acute motor axonal neuropathy (AMAN), which is an axonal classification of Guillain-Bar...")
 
(Added introduction)
Line 1: Line 1:
Abstract
== Abstract ==
This case study documents a fictional description of a patient presenting with acute motor axonal neuropathy (AMAN), which is an axonal classification of Guillain-Barre Syndrome. The patient’s experience in acute care is discussed briefly, while the patients’ sub-acute and long-term rehabilitation is covered in more detail. The purpose of this case study is to highlight approaches to assessment, outcome planning, and treatment interventions in the context of a community-based rehabilitation setting during the sub-acute phase of the disease. The case study is unique as it employs an interdisciplinary approach and ICF framework to address the pathology of the disease in a patient-specific manner.
This case study documents a fictional description of a patient presenting with acute motor axonal neuropathy (AMAN), which is an axonal classification of[[Guillain-Barre Syndrome]] . The patient’s experience in acute care is discussed briefly, while the patients’ sub-acute and long-term rehabilitation is covered in more detail. The purpose of this case study is to highlight approaches to assessment, outcome planning, and treatment interventions in the context of a community-based rehabilitation setting during the sub-acute phase of the disease. The case study is unique as it employs an interdisciplinary approach and [[International Classification of Functioning, Disability and Health (ICF)|international classification of function, disability, and health (ICF)]] framework to address the pathology of the disease in a patient-specific manner.
 
== Introduction ==
Acute motor axonal neuropathy (AMAN) is a variant type of Guillain-Barre Syndrome (GBS). AMAN is a non-inflammatory disease whereby axons of motor nerve cells are selectively targeted and destroyed by the body’s own immune system. The myelin sheath surrounding the axon is unaffected. Studies suggest that the body’s immune system specifically attacks the membrane surrounding the axon called the axolemma. AMAN is characterized by acute progressive motor weakness, areflexia, ataxia, oculomotor dysfunction and absence of sensory symptoms<ref>McGrogan, A., Madle, G. C., Seaman, H. E., & De Vries, C. S. (2009). The epidemiology of Guillain-Barré syndrome worldwide. Neuroepidemiology, 32(2), 150-163.</ref>. AMAN is typically preceded by an infection from bacteria called Campylobacter jejuni<ref>Hafer‐Macko, C., Hsieh, S. T., Ho, T. W., Sheikh, K., Cornblath, D. R., Li, C. Y., ... & Griffin, J. W. (1996). Acute motor axonal neuropathy: an antibody‐mediated attack on axolemma. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 40(4), 635-644.</ref> or Haemophilus influenzae<ref name=":0">Gabriel, C. M. (2005). Prognosis in the acute motor axonal form of Guillain–Barré syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 76(5), 622-622.</ref>. Prevalence of AMAN is estimated at 5% of cases in North America and Europe<ref>McGrogan, A., Madle, G. C., Seaman, H. E., & De Vries, C. S. (2009). The epidemiology of Guillain-Barré syndrome worldwide. Neuroepidemiology, 32(2), 150-163.</ref>, while 30-65% of cases are located in Asia, Central and South America<ref>Ravikumar, S., Poysophon, P., Poblete, R., & Kim-Tenser, M. (2016). A case of acute motor axonal neuropathy mimicking brain death and review of the literature. Frontiers in neurology, 7, 63.</ref>.
 
While the prognosis involves two categories of patients undergoing rapid recovery or slower recovery after reaching the highest levels of unchanging symptoms and dysfunction, or plateau phase<ref>Hughes RA, Rees JH. Clinical and epidemiologic features of Guillain-Barré syndrome. J Infect Dis. 1997 Dec. 176 Suppl 2:S92-8.</ref>. It is proposed that recovery is achieved through mechanisms such as terminal motor nerve axonal regeneration and collateral re-innervation processes<ref>Kuwabara, S., Ogawara, K., Mizobuchi, K., Mori, M., & Hattori, T. (2001). Mechanisms of early and late recovery in acute motor axonal neuropathy. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 24(2), 288-291.</ref>. Patients with AMAN continue to see improvements in ambulation up to four years post-diagnosis<ref name=":0" />.
 
This brings us to the purpose of the following case study of a patient with AMAN. Physiotherapy assessment and treatment can help prevent the decline of functional status and maintain functional independence, muscle strength, posture, balance, and cardio-respiratory fitness. Moreover, it enables an individual to continue performing self-care routines and activities of daily living ([[ADLs]]). In accordance to the International Classification of Functioning, Disability and Health (ICF) framework<ref>World Health Organization. (2001). International classification of functioning, disability and health: ICF.</ref>, the primary objective of this case study is to elaborate on how physical therapy rehabilitation assessment and treatment interventions can aim to address body structure and function impairments, activity limitations, and participation restrictions in patients with AMAN. The case study further aims to focus on patient-centred care and an interdisciplinary approach to assessment and management of AMAN in a community-based rehabilitation setting.

Revision as of 03:46, 13 May 2021

Abstract[edit | edit source]

This case study documents a fictional description of a patient presenting with acute motor axonal neuropathy (AMAN), which is an axonal classification ofGuillain-Barre Syndrome . The patient’s experience in acute care is discussed briefly, while the patients’ sub-acute and long-term rehabilitation is covered in more detail. The purpose of this case study is to highlight approaches to assessment, outcome planning, and treatment interventions in the context of a community-based rehabilitation setting during the sub-acute phase of the disease. The case study is unique as it employs an interdisciplinary approach and international classification of function, disability, and health (ICF) framework to address the pathology of the disease in a patient-specific manner.

Introduction[edit | edit source]

Acute motor axonal neuropathy (AMAN) is a variant type of Guillain-Barre Syndrome (GBS). AMAN is a non-inflammatory disease whereby axons of motor nerve cells are selectively targeted and destroyed by the body’s own immune system. The myelin sheath surrounding the axon is unaffected. Studies suggest that the body’s immune system specifically attacks the membrane surrounding the axon called the axolemma. AMAN is characterized by acute progressive motor weakness, areflexia, ataxia, oculomotor dysfunction and absence of sensory symptoms[1]. AMAN is typically preceded by an infection from bacteria called Campylobacter jejuni[2] or Haemophilus influenzae[3]. Prevalence of AMAN is estimated at 5% of cases in North America and Europe[4], while 30-65% of cases are located in Asia, Central and South America[5].

While the prognosis involves two categories of patients undergoing rapid recovery or slower recovery after reaching the highest levels of unchanging symptoms and dysfunction, or plateau phase[6]. It is proposed that recovery is achieved through mechanisms such as terminal motor nerve axonal regeneration and collateral re-innervation processes[7]. Patients with AMAN continue to see improvements in ambulation up to four years post-diagnosis[3].

This brings us to the purpose of the following case study of a patient with AMAN. Physiotherapy assessment and treatment can help prevent the decline of functional status and maintain functional independence, muscle strength, posture, balance, and cardio-respiratory fitness. Moreover, it enables an individual to continue performing self-care routines and activities of daily living (ADLs). In accordance to the International Classification of Functioning, Disability and Health (ICF) framework[8], the primary objective of this case study is to elaborate on how physical therapy rehabilitation assessment and treatment interventions can aim to address body structure and function impairments, activity limitations, and participation restrictions in patients with AMAN. The case study further aims to focus on patient-centred care and an interdisciplinary approach to assessment and management of AMAN in a community-based rehabilitation setting.

  1. ↑ McGrogan, A., Madle, G. C., Seaman, H. E., & De Vries, C. S. (2009). The epidemiology of Guillain-Barré syndrome worldwide. Neuroepidemiology, 32(2), 150-163.
  2. ↑ Hafer‐Macko, C., Hsieh, S. T., Ho, T. W., Sheikh, K., Cornblath, D. R., Li, C. Y., ... & Griffin, J. W. (1996). Acute motor axonal neuropathy: an antibody‐mediated attack on axolemma. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 40(4), 635-644.
  3. ↑ 3.0 3.1 Gabriel, C. M. (2005). Prognosis in the acute motor axonal form of Guillain–Barré syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 76(5), 622-622.
  4. ↑ McGrogan, A., Madle, G. C., Seaman, H. E., & De Vries, C. S. (2009). The epidemiology of Guillain-Barré syndrome worldwide. Neuroepidemiology, 32(2), 150-163.
  5. ↑ Ravikumar, S., Poysophon, P., Poblete, R., & Kim-Tenser, M. (2016). A case of acute motor axonal neuropathy mimicking brain death and review of the literature. Frontiers in neurology, 7, 63.
  6. ↑ Hughes RA, Rees JH. Clinical and epidemiologic features of Guillain-Barré syndrome. J Infect Dis. 1997 Dec. 176 Suppl 2:S92-8.
  7. ↑ Kuwabara, S., Ogawara, K., Mizobuchi, K., Mori, M., & Hattori, T. (2001). Mechanisms of early and late recovery in acute motor axonal neuropathy. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 24(2), 288-291.
  8. ↑ World Health Organization. (2001). International classification of functioning, disability and health: ICF.
Retrieved from "https://www.physio-pedia.com/index.php?title=Acute_Motor_Axonal_Neuropathy_(AMAN),_a_Variant_of_Guillain-Barre_Syndrome:_A_Case_Study&oldid=273014"