External and internal ophthalmoplegia,facial diplegia,ataxia and exaggerated deep tendon reflexes associated with anti-GQ1b antibodies: A new variant of acute ophthalmoparesis
Available accessCase reportFirst published online February, 2010
External and internal ophthalmoplegia,facial diplegia,ataxia and exaggerated deep tendon reflexes associated with anti-GQ1b antibodies: A new variant of acute ophthalmoparesis
We present the case report of a patient with antibodies to ganglioside GQ1b, who presented with pupillary areflexia, external ophthalmoplegia, ataxia, brisk deep tendon reflexes and facial muscle diplegia following a viral illness. The patient was diagnosed with acute ophthalmoparesis, which is a rare variant of Miller Fisher syndrome that has been characterised recently. We describe a unique presentation of this rare condition, and consider the range of presentations that can occur in association with antibodies to the GQ1b ganglioside.
MoriM, KuwabaraS, FukutakeT, YukiN, HattoriT.Clinical features and prognosis of Miller Fisher syndrome. Neurology2001; 56(8): 1104–1106.
3.
OverellJR, HsiehST, OdakaM, YukiN, WillisonHJ.Treatment for Fisher syndrome, Bickerstaff s brainstem encephalitis and related disorders. Cochrane Database Syst Rev2007; (1):CD004761.
4.
WillisonHJ, VeitchJ, PatersonG, KennedyPG.Miller Fisher syndrome is associated with serum antibodies to GQ1b ganglioside. J Neurol Neurosurg Psychiatry1993; 56(2): 204–206.
5.
ChibaA, KusunokiS, ObataH, MachinamiR, KanazawaISerum anti-GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain-Barre syndrome: clinical and immunohistochemical studies. Neurology1993; 43(10): 1911–1917.
6.
JacobsBC, RothbarthPH, Van der MecheFG, HerbrinkP, SchmitzPI, De KlerkMA.The spectrum of antecedent infections in Guillain-Barre syndrome: a case-control study. Neurology1998; 51(4): 1110–1115.
7.
OdakaM, YukiN, YamadaM, KogaM, TakemiT, HirataK.Bickerstaff s brainstem encephalitis: clinical features of 62 cases and a subgroup associated with Guillain-Barre syndrome. Brain2003; 126(Pt 10): 2279–2290.
8.
ChanYC, Wilder-SmithE, CheeMW.Acute ophthalmoplegia with pupillary areflexia associated with anti-GQ1b antibody. J Clin Neurosci2004; 11(6): 658–660.
9.
GalassiG, SusukiK, QuaglinoD, YukiN.Post-infectious acute ataxia and facial diplegia associated with anti-GD1a IgG antibody. Eur J Neurol2004; 11(11): 790–791.
10.
SusukiK, AtsumiM, KogaM, HirataK, YukiN.Acute facial diplegia and hyperreflexia: A Guillain-Barre syndrome variant. Neurology2004; 62(5): 825–827.
11.
YukiN, HirataK.Preserved tendon reflexes in Campylobacter neuropathy. Ann Neurol1998; 43(4): 546–547.
12.
KuwabaraS, OgawaraK, KogaM, MoriM, HattoriT, YukiN.Hyperreflexia in Guillain-Barre syndrome: relation with acute motor axonal neuropathy and anti-GM1 antibody. J Neurol Neurosurg Psychiatry1999; 67(2): 180–184.
