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Background: Acute motor sensory axonal neuropathy (AMSAN) is a severe form of Guillain–Barré syndrome, which typically is not related to ocular palsy, and is pathologically associated with antibodies against GM1 and GD1a gangliosides. Case presentation: We present a patient with a severe, drug‐resistant form of AMSAN with ophthalmoplegia related to antiganglioside (anti‐GD1a, ‐GD1b, ‐GM1) antibodies in the serum and cerebrospinal fluid, and with a poor long‐term outcome. Conclusions: Rare cases of AMSAN with ophthalmoplegia are described in the literature. The present patient is a case of an unusual clinical phenotype of AMSAN, the characteristics of which warn of a serious clinical course that requires timely aggressive treatment. [ABSTRACT FROM AUTHOR]

Guillain–Barré syndrome is an acute immune‐mediated demyelinating disease. Typical features include progressive ascending lower extremity weakness and areflexia. Several variants have been described that can make the diagnosis challenging. Here, we report a case of GBS presenting with progressive lower limb weakness and T6 sensory level. To bring attention to the wide spectrum of presentation of Guillain–Barre syndrome by presenting a rare, atypical variant with a sensory level which was successfully managed by our team so that clinicians keep this deferential in mind when they face patients with such neurological manifestation. [ABSTRACT FROM AUTHOR]

In the early stage of disease, differentiating acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor sensory axonal neuropathy (AMSAN) using only a conventional nerve conduction studies (NCS) may be difficult. We evaluated the differences in the motor axonal excitability properties of 16 cases of sensorimotor Guillain-Barré syndrome by nerve excitability testing (NET). The antiganglioside antibody assay and follow-up NCS resulted in 12 patients diagnosed as AIDP and 4 patients as AMSAN. Clinical and excitability parameters in each group were compared with those in 30 normal controls. Automated NET with threshold tracking techniques was used to calculate the strength-duration time constant (SDTC), threshold electrotonus (TE), current-threshold relationship (CTR), and recovery cycle (RC) of excitability. Except for subtle changes in excitability parameters, AIDP showed no definitive difference relative to normal controls. Comparison between AMSAN and normal controls also revealed no significant differences in the SDTC, TE, and CTR parameters. However, there were clear differences in some of the RC parameters: the relative refractory period was significantly longer in the AMSAN group than in the AIDP group (4.40 ± 1.11 vs. 3.09 ± 1.01 ms, mean ± SEM; p < 0.001), while superexcitability was significantly less prominent in the AMSAN group (−6.80 ± 10.30 vs. −26.48 ± 1.17%, mean ± SEM; p < 0.001). Our study identified that both AIDP and AMSAN were associated with subtle changes in excitability properties. Nonetheless, the prominent increase in refractoriness in AMSAN suggests the presence of a nodal conduction block. [ABSTRACT FROM AUTHOR]