Hatano Taku, Shimada Yoshiaki, Kono Ayako, Kubo Shin-ichiro, Yokoyama Kazumasa, Yoritaka Asako, Nakahara Toshiki, Takahashi Yukitoshi, Hattori Nobutaka
Department of Neurology, Juntendo University, School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan.
BMJ Case Rep. 2011 Sep 8;2011:bcr0820103228. doi: 10.1136/bcr.08.2010.3228.
The present study reports a young woman with acute ataxia, areflexia and ophthalmoplegia, accompanied by psychosis and involuntary movements (IVMs) from disease onset. Anti-GQ1b and anti-GT1a antibodies were detected allowing for a diagnosis of Miller Fisher syndrome (MFS). However, psychosis and IVMs are atypical MFS symptoms and often mimic symptoms of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Interestingly, the autoantibodies against full-length glutamate receptor-ε2 (GluRε2) and glutamate NR2B- and NR2A-containing heteromers (NR1/NR2) of NMDAR were also detected in the patient serum and cerebrospinal fluid. It was concluded that psychosis and IVMs in this patient were associated with autoantibodies against various GluRs.
本研究报告了一名年轻女性，自发病起即伴有急性共济失调、腱反射消失和眼肌麻痹，并伴有精神病和不自主运动（IVM）。检测到抗GQ1b和抗GT1a抗体，从而诊断为米勒费雪综合征（MFS）。然而，精神病和IVM是MFS的非典型症状，常类似抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎的症状。有趣的是，在患者血清和脑脊液中还检测到了针对全长谷氨酸受体-ε2（GluRε2）以及NMDAR含谷氨酸NR2B和NR2A的异聚体（NR1/NR2）的自身抗体。得出的结论是，该患者的精神病和IVM与针对各种GluR的自身抗体有关。
