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In acute motor axonal neuropathy (AMAN), deep tendon reflexes are occasionally preserved or exaggerated,1-5⇓⇓⇓⇓ although the mechanism is unknown. We report the first known patient with AMAN presenting hyperreflexia in whom a CNS lesion was detected by MRI.
Case report.
A previously healthy 22-year-old woman felt numbness and weakness in her right upper limb 5 days after resolution of febrile condition with cough (day 1). She did not have preceding diarrhea. The weakness spread to other limbs, and she could not walk without assistance on day 3. She was admitted on day 7. Her consciousness and eye movement were intact. Neither facial nor bulbar palsy was noted. Muscle strength in her four limbs was symmetrically decreased to Medical Research Council grade 3. The deep tendon reflexes were remarkably hyperactive in all limbs and muscle tonus was spastic in lower limbs. The plantar response was extensor on the left side. Mild palmar and plantar hypalgesia were noted, and …
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