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AMAN GBS Variant — SCE Infectious Diseases MCQ

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HardCNS InfectionAMAN GBS VariantSCE Infectious Diseases

A 30-year-old woman presents with acute onset flaccid areflexic paralysis affecting all four limbs 3 weeks after a diarrhoeal illness. Campylobacter jejuni serology is positive. Nerve conduction studies show a pure motor axonal neuropathy without demyelination. What GBS variant is this?

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Correct answer: D — Acute motor axonal neuropathy (AMAN) — the axonal variant of GBS, strongly associated with preceding C. jejuni infection and anti-GM1 ganglioside antibodies

AMAN is an axonal variant of GBS characterised by pure motor involvement with axonal degeneration (not demyelination) on NCS. It is strongly associated with preceding C. jejuni infection and anti-GM1/anti-GD1a ganglioside antibodies. It is more common in Asia and Central America than in Europe (where AIDP predominates). Treatment is the same as for AIDP (IVIG or plasma exchange). Recovery may be slower than demyelinating GBS due to axonal damage requiring nerve regeneration. Miller Fisher syndrome (ataxia, ophthalmoplegia, areflexia) is associated with anti-GQ1b antibodies.

Reference: NICE NG220 2022 – GBS; Lancet Neurol 2019 – GBS variants