Department of Neurology, Wakayama Medical University, Wakayama, Japan.
Department of Neurology, Wakayama Medical University, Wakayama, Japan; Department of Neurology, Kindai University School of Medicine, Osaka, Sayama, Japan.
J Neuroimmunol. 2022 Jul 15;368:577880. doi: 10.1016/j.jneuroim.2022.577880. Epub 2022 Apr 25.
Ophthalmoplegia is a common neurological finding in Miller Fisher syndrome (MFS), but acute eye movement-retained internal ophthalmoplegia is a rare variant of MFS. In this report, we present three cases of acute eye movement-retained internal ophthalmoplegia; IgG anti-GQ1b antibodies were detected in all patients. We reviewed a total of 13 cases, including 10 previously reported cases, and revealed that IgG anti-GQ1b antibodies were identified in all but one patient. In addition, we investigated the correlation between acute eye movement-retained internal ophthalmoplegia and antibodies against ganglioside complexes. We found that anti-GQ1b antibodies in our patients reacted with GQ1b or GT1a but not GQ1b/GM1 or GQ1b/GD1a complexes, indicating that antibodies against disialosyl residues have a pathogenetic role in acute eye movement-retained internal ophthalmoplegia. This is the first study describing that acute eye movement-retained internal ophthalmoplegia is associated with IgG antibodies specific to GQ1b or GT1a.
眼肌麻痹是 Miller Fisher 综合征（MFS）的常见神经学表现，但急性眼球运动保留性眼肌麻痹是 MFS 的一种罕见变异。在本报告中，我们介绍了三例急性眼球运动保留性眼肌麻痹病例；所有患者均检测到 IgG 抗-GQ1b 抗体。我们共复习了 13 例病例，包括 10 例先前报道的病例，发现除 1 例外所有患者均存在 IgG 抗-GQ1b 抗体。此外，我们还研究了急性眼球运动保留性眼肌麻痹与神经节苷脂复合物抗体之间的相关性。我们发现，我们患者中的抗-GQ1b 抗体与 GQ1b 或 GT1a 反应，但不与 GQ1b/GM1 或 GQ1b/GD1a 复合物反应，表明针对二唾液酸残基的抗体在急性眼球运动保留性眼肌麻痹中具有致病作用。这是首次描述急性眼球运动保留性眼肌麻痹与针对 GQ1b 或 GT1a 的 IgG 抗体相关的研究。
