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Acute ophthalmoplegia in a patient with anti-GQ1b antibody and chronic facial diplegia.
BMJ Case Rep. 2020 Jul 09; 13(7)BC

Abstract

A 56-year-old man with a remote history of bilateral recurrent facial palsies presented with a week of ophthalmoplegia with intact deep tendon reflexes and lack of ataxia, cerebrospinal fluid with albuminocytologic dissociation and elevated serum anti-ganglioside Q1b (GQ1b) IgG antibody. We diagnosed the patient with acute ophthalmoplegia without ataxia, a condition under the spectrum of anti-GQ1b antibody syndromes which also includes Miller Fisher syndrome. Given the rarity of recurrent facial palsies and anti-GQ1b antibody syndromes as well as reports associating facial palsies and this syndrome, we suggest that our case may be an unusual presentation of an anti-GQ1b antibody syndrome beginning with recurrent facial palsies several years prior to ophthalmoplegia. Prior studies of human nerves provide insight into the pathophysiology, including ganglioside distribution and cross-reactivities underlying the heterogeneity of anti-GQ1b antibody syndromes. This report may expand the differential diagnosis in patients with recurrent facial palsies and broaden the phenotype of anti-GQ1b syndromes.

Authors+Show Affiliations

Department of Neurosciences, University of California San Diego Health System, San Diego, California, USA fhdu@ucsd.edu.Department of Neurology, University of California Los Angeles Health System, Los Angeles, California, USA.Department of Neurosciences, University of California San Diego Health System, San Diego, California, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32646933

Citation

Du, Fanny Huynh, et al. "Acute Ophthalmoplegia in a Patient With anti-GQ1b Antibody and Chronic Facial Diplegia." BMJ Case Reports, vol. 13, no. 7, 2020.
Du FH, Yerevanian A, Shtrahman M. Acute ophthalmoplegia in a patient with anti-GQ1b antibody and chronic facial diplegia. BMJ Case Rep. 2020;13(7).
Du, F. H., Yerevanian, A., & Shtrahman, M. (2020). Acute ophthalmoplegia in a patient with anti-GQ1b antibody and chronic facial diplegia. BMJ Case Reports, 13(7). https://doi.org/10.1136/bcr-2020-234319
Du FH, Yerevanian A, Shtrahman M. Acute Ophthalmoplegia in a Patient With anti-GQ1b Antibody and Chronic Facial Diplegia. BMJ Case Rep. 2020 Jul 9;13(7) PubMed PMID: 32646933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute ophthalmoplegia in a patient with anti-GQ1b antibody and chronic facial diplegia. AU - Du,Fanny Huynh, AU - Yerevanian,Alexan, AU - Shtrahman,Matthew, Y1 - 2020/07/09/ PY - 2022/07/09/pmc-release PY - 2020/7/11/entrez PY - 2020/7/11/pubmed PY - 2020/7/11/medline KW - cranial nerves KW - immunology KW - neuromuscular disease KW - neuroopthalmology KW - skin JF - BMJ case reports JO - BMJ Case Rep VL - 13 IS - 7 N2 - A 56-year-old man with a remote history of bilateral recurrent facial palsies presented with a week of ophthalmoplegia with intact deep tendon reflexes and lack of ataxia, cerebrospinal fluid with albuminocytologic dissociation and elevated serum anti-ganglioside Q1b (GQ1b) IgG antibody. We diagnosed the patient with acute ophthalmoplegia without ataxia, a condition under the spectrum of anti-GQ1b antibody syndromes which also includes Miller Fisher syndrome. Given the rarity of recurrent facial palsies and anti-GQ1b antibody syndromes as well as reports associating facial palsies and this syndrome, we suggest that our case may be an unusual presentation of an anti-GQ1b antibody syndrome beginning with recurrent facial palsies several years prior to ophthalmoplegia. Prior studies of human nerves provide insight into the pathophysiology, including ganglioside distribution and cross-reactivities underlying the heterogeneity of anti-GQ1b antibody syndromes. This report may expand the differential diagnosis in patients with recurrent facial palsies and broaden the phenotype of anti-GQ1b syndromes. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/32646933/Acute_ophthalmoplegia_in_a_patient_with_anti-GQ1b_antibody_and_chronic_facial_diplegia L2 - https://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=32646933 DB - PRIME DP - Unbound Medicine ER -
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