TY  - BOOK
AU  - Magtoto, John Kenneth Y., MD.
TI  - A Rare case of guillain  barre syndrome AMSAN variant / 
AV  - MED 2020 0006 
PY  - 2020///
CY  - Fairview, Quezon City
PB  - Department of Internal Medicine, FEU-NRMF
N1  - Includes appendices and bibliographical references; RESDM
N2  - Abstract:  Patients' chief complaint guides physicians on how to approach a certain cases while having the most probable diagnoses at the back of their minds. This is a case of a 50-year-old female presenting with left sided facial and body numbness. Her sensorium was intact, with associated ptosis of the left eye, dysphagia, slurring of speech, and left sided body weakness. Upon further eliciting an in-depth history, Guillain Barre Syndrome (GBS) was entertained. An early recognition of the signs and symptoms, along with a high index of suspicion, has lead to avoidance in delay in the diagnosis. The initial EMG NCV done was not definitive at that time because it showed no electrophysiologic evidence for an immune-mediated polyneuropathy yet. However, due to the acuteness of the symptoms, absence of F wave responses, and absence of H-reflex, GBS was still suspected. Even though the initial result was not definitive, patient still was still immediately treated with a course of IVIg for 5 days. A repeat EMG NCV was done after a week revealed diffuse bilateral symmetric distal more than proximal, predominantly axonal sensorimotor polyneuropathy involving the lower limbs and upper extremities, thus confirming the diagnosis of Guillain Barre Syndrome - Acute Motor Sensory Axonal Neuropathy (AMSAN) variant. In an inexperienced eye, diagnosis of GBS-AMSAN variant might be mistaken for other disease entities. Time is gold in the treatment of GBS because it is common to have pulmonary complications due to muscle paralysis. The prompt initiation of treatment is assumed to lead to a better prognosis, and to an extent, decrease the risk of serious long term complications to the patient.
ER  -