Finger drop sign as a new variant of acute motor axonal neuropathy.
Byeol-A YoonDong-Ho HaHwan Tae ParkSusumu KusunokiMotoi KuwaharaJong Hwa LeeJong Seok BaeJong Kuk KimPublished in: Muscle & nerve (2020)
We propose the finger drop sign as a new clinical variant of acute motor axonal neuropathy (AMAN) defined by immunological and radiological evidence. We identified eight consecutive patients who had AMAN. All of them developed prominent involvement of the finger extensors. We performed magnetic resonance imaging (MRI) of the extremity muscles and serological assays for antiganglioside antibodies and Campylobacter jejuni. Patients with AMAN showed characteristic and a markedly sustained weakness of the finger extensors with a distinctive pattern of the finger drop sign. Limb MRI revealed unevenly distributed abnormal signals in the muscles mainly innervated by the posterior interosseous nerve. All tested patients showed positivity for immunoglobulin G antibody against ganglioside complex of GM1 and phosphatidic acid. A pathophysiological understanding of this unique syndrome can provide further insight into antiganglioside-antibody-mediated axonal injury in Guillain-Barré syndrome.
Keyphrases
- magnetic resonance imaging
- spinal cord injury
- contrast enhanced
- liver failure
- end stage renal disease
- respiratory failure
- computed tomography
- ejection fraction
- newly diagnosed
- drug induced
- diffusion weighted imaging
- case report
- chronic kidney disease
- prognostic factors
- optic nerve
- single cell
- magnetic resonance
- intensive care unit
- escherichia coli
- hepatitis b virus
- staphylococcus aureus
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- antimicrobial resistance
- candida albicans
- cystic fibrosis