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Acute Intermittent Porphyria Mimic of Guillain-Barré Syndrome: A Case Report with the Use of Osteopathic Manipulation for Management of Pain

Journal: The AAO Journal Date: 2005/03, 15(1):Pages: 29-32, type of study: case report

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

acute intermittent porphyria [1]
case report [514]
Guillain-Barré syndrome [1]
OMT [2951]
osteopathic manipulative treatment [2973]

Abstract:

Motor neuropathies include a wide spectrum of clinical presentations and an extensive differential diagnosis. Muscle weakness commonly occurs in patients with an attack of Acute Intermittent Porphyria (AlP) and clinical presentation can mimic Guillain-Barré Syndrome. Both AlP and Guillain-Barré Syndrome (GBS) can be preceded by abdominal symptoms that are followed by a progressive motor paralysis with or without sensory disturbance and including some respiratory paralysis. The pathologic changes have been described as either peripheral demyelination (GBS) or axonal degeneration (AIP). Cohen et al. describes a patient with AlP that presented with severe bilateral leg pain and weakness, which progressively worsened; however there is little in the literature to discuss the rehabilitation procedure necessary for management of long term weakness or pain following attacks of AIP. The following case represents an interesting incorporation of both the diagnoses of GBS and AIP. Refractory to the primary treatment for GBS and positive urine analysis for porphyria, it is still unclear the exact cause of his symptoms. None the less, the patient possesses a profound debilitating pain that remains following initial acute peripheral motor neuropathy presentation five years ago. Literature is lacking with regards to the rehabilitation benefits of osteopathic manipulative medicine in such complicated cases where standard modalities of treatment provide little relief of pain.


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