Taguchi Y, Takashima S, Inoue H, Kusunoki S
Second Department of Internal Medicine, Toyama Medical & Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
No To Shinkei. 2001 Mar;53(3):275-8.
We report herein a rare case of Miller Fisher syndrome with pharyngeal palsy as an initial symptom. A 68-year-old man admitted to our hospital with pharyngeal palsy two weeks after a respiratory infection. He subsequently developed ataxic gait, paresthesia in the upper limbs and ophthalmoplegia. Double-filtrated-plasmapheresis had been performed four times and all the symptoms subsided within two months. In the acute phase of the disease, the titers of anti-GQ1b and GT1a antibodies were elevated. The titer of anti-GT1a antibody was higher than that of anti-GQ1b antibody. Recently, the activity of serum anti-GT1a antibody has been supposed to be associated with pharyngeal palsy. In the present case, higher titer of anti-GT1a antibody compared with that of anti-GQ1b antibody could possibly cause pharyngeal palsy as an initial symptom of Miller Fisher syndrome.
我们在此报告一例罕见的以咽肌麻痹为首发症状的米勒-费希尔综合征。一名68岁男性在呼吸道感染两周后因咽肌麻痹入住我院。随后他出现共济失调步态、上肢感觉异常和眼肌麻痹。进行了四次双重过滤血浆置换，所有症状在两个月内消退。在疾病急性期，抗GQ1b和GT1a抗体滴度升高。抗GT1a抗体滴度高于抗GQ1b抗体滴度。近来，血清抗GT1a抗体活性被认为与咽肌麻痹有关。在本病例中，抗GT1a抗体滴度高于抗GQ1b抗体滴度可能是导致咽肌麻痹作为米勒-费希尔综合征首发症状的原因。
