open access

Vol 45, No 3 (2011)
OPIS PRZYPADKU
Submitted: 2010-06-10
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Total ocular akinesis: Miller Fisher or Guillain-Barré syndrome?

Kinga Rajska, Jacek Rożniecki, Piotr Loba, Małgorzata Zielińska, Anna Broniarczyk-Loba
DOI: 10.1016/S0028-3843(14)60083-9
·
Neurol Neurochir Pol 2011;45(3):297-300.

open access

Vol 45, No 3 (2011)
OPIS PRZYPADKU
Submitted: 2010-06-10

Abstract

Total, bilateral ophthalmoplegia is very rare. More than 50% of cases are Miller Fisher (MFS) and Guillain-Barré (GBS) syndromes. There is a correlation of MFS with anti-GQ1b antibodies. High levels of GQ1b gangliosides are found in myelin sheathes of cranial nerves supplying the extraocular muscles. This may explain the association of anti-GQ1b antibodies with ophthalmoplegia. Anti-GQ1b were also found in cases of GBS accompanied by ophthalmoplegia, atypical MFS (MFS without ataxia), MFS/GBS overlap syndromes and Bickerstaff brainstem encephalitis. This has led some authors to classify them as ‘anti-GQ1b syndromes’.

In this article we describe a diagnostically difficult case of a patient with a very rare, total bilateral paralysis of all ocular muscles, accompanied by bilateral ptosis, diminished tendon reflexes of upper extremities, paresis and hypoesthesia of the left upper extremity.

Abstract

Total, bilateral ophthalmoplegia is very rare. More than 50% of cases are Miller Fisher (MFS) and Guillain-Barré (GBS) syndromes. There is a correlation of MFS with anti-GQ1b antibodies. High levels of GQ1b gangliosides are found in myelin sheathes of cranial nerves supplying the extraocular muscles. This may explain the association of anti-GQ1b antibodies with ophthalmoplegia. Anti-GQ1b were also found in cases of GBS accompanied by ophthalmoplegia, atypical MFS (MFS without ataxia), MFS/GBS overlap syndromes and Bickerstaff brainstem encephalitis. This has led some authors to classify them as ‘anti-GQ1b syndromes’.

In this article we describe a diagnostically difficult case of a patient with a very rare, total bilateral paralysis of all ocular muscles, accompanied by bilateral ptosis, diminished tendon reflexes of upper extremities, paresis and hypoesthesia of the left upper extremity.

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Keywords

ophthalmoplegia, Miller Fisher syndrome, Guillain-Barré syndrome

About this article
Title

Total ocular akinesis: Miller Fisher or Guillain-Barré syndrome?

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 45, No 3 (2011)

Pages

297-300

DOI

10.1016/S0028-3843(14)60083-9

Bibliographic record

Neurol Neurochir Pol 2011;45(3):297-300.

Keywords

ophthalmoplegia
Miller Fisher syndrome
Guillain-Barré syndrome

Authors

Kinga Rajska
Jacek Rożniecki
Piotr Loba
Małgorzata Zielińska
Anna Broniarczyk-Loba

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