Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea.
Department of Neurology, Biomedical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, South Korea.
J Neurol. 2019 Feb;266(2):476-479. doi: 10.1007/s00415-018-9161-8. Epub 2018 Dec 17.
To define the prevalence and characteristics of single ocular motor nerve palsy (OMNP) associated with positive serum anti-GQ1b antibody. We performed a prospective multicenter study that recruited 82 patients with single OMNP without identifiable causes from the history and neuroimaging in six neurology clinics of university hospitals. We measured serum anti-GQ1b antibody in all participants. Twelve patients with multiple OMNP and 30 with identifiable causes served as the controls. Overall, the prevalence of anti-GQ1b antibody syndrome was 10% (8/82) in patients with single OMNP and 6% (5/78) in those with single OMNP in isolation. None of the 14 patients with OMNP with identifiable causes showed positive serum anti-GQ1b antibody. The prevalence of anti-GQ1b antibody syndrome was much higher in patients with multiple OMNP than in those with single OMNP (50% vs. 10%, p < 0.01). Patients with single OMNP and positive anti-GQ1b antibody are younger (42 ± 16 vs. 58 ± 15, p < 0.05) and had a significantly higher frequency of preceding infection (75 vs. 19%, p < 0.05) and other neurological signs (38 vs. 1%, p < 0.05) than those with negative antibody. Eight patients with single OMNP and positive serum anti-GQ1b antibody involved the abducens (n = 6), trochlear (n = 1), or oculomotor nerve (n = 1). Single OMNP accompanying other neurological signs and multiple OMNP are more likely to be associated with anti-GQ1b antibody. Anti-GQ1b antibody syndrome should be considered even in patients with single OMNP, especially when antecedent infection was associated in younger patients.
为了明确与血清抗-GQ1b 抗体阳性相关的单眼运动神经麻痹（OMNP）的患病率和特征。我们进行了一项前瞻性多中心研究，该研究从病史和神经影像学方面共招募了 6 家大学附属医院的 6 个神经内科的 82 例无明显病因的单眼运动神经麻痹患者。我们对所有参与者均进行了血清抗-GQ1b 抗体检测。12 例多眼运动神经麻痹患者和 30 例有明确病因的患者作为对照。总体而言，82 例单眼运动神经麻痹患者中抗-GQ1b 抗体综合征的患病率为 10%（8/82），而 78 例单眼运动神经麻痹患者中抗-GQ1b 抗体综合征的患病率为 6%（5/78）。无明显病因的 14 例运动神经麻痹患者的血清抗-GQ1b 抗体均为阴性。多眼运动神经麻痹患者的抗-GQ1b 抗体综合征的患病率明显高于单眼运动神经麻痹患者（50% vs. 10%，p<0.01）。单眼运动神经麻痹且血清抗-GQ1b 抗体阳性的患者更年轻（42±16 岁 vs. 58±15 岁，p<0.05），且前驱感染（75% vs. 19%，p<0.05）和其他神经体征（38% vs. 1%，p<0.05）的频率明显更高。单眼运动神经麻痹且血清抗-GQ1b 抗体阳性的 8 例患者中，涉及外展神经（n=6）、滑车神经（n=1）或动眼神经（n=1）。伴有其他神经体征的单眼运动神经麻痹和多眼运动神经麻痹更可能与抗-GQ1b 抗体相关。即使在单眼运动神经麻痹患者中，也应考虑抗-GQ1b 抗体综合征，尤其是在年轻患者伴有前驱感染时。
