Acute motor conduction block neuropathy followed by axonal degeneration and poor recovery

Abstract

Acute motor neuropathies with conduction block are rare and often fully recover within weeks without residual axonal involvement.1,2 We report a case occurring after Campylobacter jejuni infection, with anti-GM1 antibody positivity, which presented axonal degeneration. Clinical improvement remained minimal 6 months after onset. This 50-year-old woman presented, 4 weeks after a gastrointestinal illness, with weakness of the lower limbs, which progressed to the arms over 3 days. Her past personal and family medical histories were unremarkable. On examination, she had weakness proximally and distally in all limbs (grade 2 on the Medical Research Council [MRC] scale). Sensory examination showed mild distal hypoesthesia to pinprick and vibration sense up to the ankles. She was areflexic, and plantar reflexes were flexor. Cranial nerve functions were unimpaired. All routine blood investigations were normal. C. jejuni serology for IgM (1:640) and IgG anti-GM1 antibodies were positive. CSF examination done 6 days after onset of the weakness showed no cells and protein level of 0.36 g/L …