October 1996 - Rapidly progressive weakness

One week after a flu-like illness, a 51-year-old woman developed rapidly progressive weakness. Within three weeks, she required mechanical ventilation. A neurological exam revealed severe motor involvement with normal sensory findings confirmed by nerve conduction studies. Five days after intubation a catastrophic brain hemorrhage occurred. Autopsy showed severe loss of axons in the motor roots with periaxonal macrophages and no lymphocytes. These findings are typical of acute motor axonal neuropathy, which is rare in the United States.