J Korean Dysphagia Soc.  2021 Jan;11(1):72-77. 10.34160/jkds.2021.11.1.010.

Dysgeusia as Anti-GQ1b Antibody Syndrome with Brainstem Involvement: A Tractography Case Report

Affiliations
  • 1Departments of Rehabilitation Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
  • 2Department of Rehabilitation Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Dysgeusia and dysphagia are rarely reported as the sole clinical symptoms of anti-GQ1b antibody syndrome involving the cranial nerves (CN). According to previous reports, those exhibiting bilateral facial nerve palsy or ophthalmoplegia or both are followed by bulbar dysfunctions (CNs IX and X). This paper reports a case of a 22-year-old man showing dysgeusia with dysphagia and mild limb weakness. Fiberoptic endoscopy revealed signs of residues after swallowing. The nerve conduction study (NCS) in the limbs and conventional brain magnetic resonance imaging were normal. Further workup revealed a positive serum anti-GQ1b antibody. The diffusion tension weighted brain images with tractography revealed involvement to the bilateral corticobulbar and corticospinal tract at the brainstem level. Although his normal NCS and conventional brain MRI made the diagnosis difficult, it was confirmed to be a rare variant of anti-GQ1b antibody syndrome showing corticobulbar and corticospinal tract involvement. The patient showed excellent recovery after dysphagia treatment.

Keyword

GQ1b ganglioside; Dysgeusia; Deglutition disorder; Glossopharyngeal nerve; Corticobulbar tract
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