Patient handout

Guillain-Barré Syndrome — AMAN (acute motor axonal)

PRODUCTION

1. Your condition

This handout is for guillain-barré syndrome — aman (acute motor axonal). Your care team identified this based on: pure motor ascending symmetric weakness with preserved sensation; areflexia (van doorn 2011 pmid 25023340).

Other reasons your team may use this plan: preceding campylobacter jejuni gastroenteritis (diarrhea) 1-3 wk prior — strong aman association (yuki 2007 pmid 22694000); ncs pure motor axonal pattern: reduced cmap amplitudes without slowing; preserved sensory ncs (van doorn 2011 pmid 25023340); anti-gm1 / anti-gd1a antibodies positive (~60-80% in aman) (yuki 2007 pmid 22694000).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
ivig	0.4 g/kg/d × 5 d (total 2 g/kg)	IV	daily × 5 d	Hughes Cochrane 2014 PMID 25238327 — IVIG and PLEX equivalent in AMAN; check IgA pre-IVIG (EAN/PNS 2023)
plasmapheresis (PLEX)	5 sessions over 7-10 d (q48h)	IV	5 sessions q48h	Raphael Cochrane PMID 22786475 — equivalent; do NOT combine

Plan: AMAN — IVIG/PLEX (same dose as AIDP) + extended rehab planning (Hughes Cochrane 2014 PMID 25238327; van Doorn 2011)

3. When to call your provider

Contact your care team if any of the following happen:

Worsening / new weakness >8 wk → CIDP workup (van Doorn 2011)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

AMAN signature: reduced CMAP without slowing + preserved sensory NCS = pure motor axonal pattern; pivots away from AIDP demyelinating (van Doorn 2011 PMID 25023340)
Preceding Campylobacter jejuni gastroenteritis 1-3 wk prior — strong AMAN risk; molecular mimicry between LOS and GM1/GD1a gangliosides (Yuki 2007 PMID 22694000)
Anti-GM1 and/or anti-GD1a antibodies positive — supports AMAN diagnosis (~60-80% positivity in AMAN) (Yuki 2007 PMID 22694000)
Pediatric AMAN — high prevalence in Asian children especially during Campylobacter outbreaks (van Doorn 2011 PMID 25023340)
AMAN often more rapid than AIDP — quadriparesis within 24-48 h; high EGRIS risk → immediate ICU (IGOS Doets 2018 PMID 30247567; Walgaard 2009 PMID 20517939)(life-threatening)

5. Follow-up

Neuro rehab (often longer than AIDP due to axonal loss), CIDP surveillance, psychology (NICE 2024)

6. Sources

Guideline: 2023 EAN/PNS GBS Guideline + Hughes Cochrane 2014 + Yuki 2007 (Campylobacter molecular mimicry)