J Korean Ophthalmol Soc.  2019 Dec;60(12):1284-1289. 10.3341/jkos.2019.60.12.1284.

Clinical Features of Acute Opthalmoplegia Associated with Anti-GQ1b Antibody

• Han SH
• Oh SY
• Park KA

• KMID: 2466183
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1284

Abstract

PURPOSE
To investigate the clinical features of acute ophthalmoplegia associated with anti-GQ1b antibody in the Republic of Korea.
METHODS
From January 2011 to July 2018, we retrospectively reviewed the medical records of all patients who tested positive for anti-GQ1b antibody, and who had been concurrently diagnosed with acute ophthalmoplegia at a tertiary hospital in the Republic of Korea. Ophthalmic and neurological features were carefully reviewed. Laboratory results including ganglioside antibody panels and treatment outcomes were analyzed.
RESULTS
Thirty-three patients were enrolled in the study and 8 (24%) of them showed pure Miller-Fisher syndrome with all three cardinal symptoms of ophthalmoplegia, ataxia, and areflexia. One patient (3%) showed ophthalmoplegia, areflexia, and pharyngeal- cervical-brachial weakness without ataxia and 2 patients (6%) showed only ophthalmoplegia and pharyngeal-cervical- brachial weakness without ataxia and areflexia. Twenty-two patients (67%) showed only ophthalmoplegia without any other neurological symptom. Early immunosuppressant treatment was used to treat 17 patients, and observation only was conducted as the initial treatment for 16 patients (48.5%). Twenty-four patients (72.7%) showed improvement and 9 patients showed persistent strabismus and diplopia. The average duration until recovery was 2.52 ± 2.11 months.
CONCLUSIONS
The symptoms of acute ophthalmoplegia associated with anti-GQ1b antibody can manifest in various forms that overlap with clinical features of demyelinating neuropathy, so it is important to recognize such characteristics when treating acute ophthamoplegia.

Keyword

Acute ophthalmoplegia; Anti-GQ1b antibody; Areflexia; Ataxia; Atypical Miller-Fisher syndrome

MeSH Terms

Ataxia
Diplopia
Humans
Medical Records
Miller Fisher Syndrome
Ophthalmoplegia
Republic of Korea
Retrospective Studies
Strabismus
Tertiary Care Centers

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