Shen Donghui, Liu Kang, Wang Haifeng
Department of Neurology, Qingdao Municipal Hospital, Qingdao, Shan dong Province 266000, China.
Department of Stomatology, Qingdao Municipal Hospital, Qingdao, Shan dong Province 266000, China.
Clin Neurol Neurosurg. 2025 Aug 24;258:109121. doi: 10.1016/j.clineuro.2025.109121.
We present a rare case of a 56-year-old female presenting with overlapping features of Miller Fisher syndrome (MFS), Bickerstaff's brainstem encephalitis (BBE) and Guillain-Barré syndrome (GBS), despite seronegativity for anti-GQ1b, GM1, GD1b, GT1a, and GT1b IgG antibodies. The patient developed sequential neurological deficits (ophthalmoplegia, ataxia, tetraparesis, and altered consciousness) following an upper respiratory infection. Electrophysiological studies confirmed acute motor-sensory axonal neuropathy, while cerebrospinal fluid analysis showed albuminocytological dissociation. Dual intravenous immunoglobulin (IVIG) courses and methylprednisolone therapy led to partial recovery, with independent ambulation achieved by day 76. This case underscores the complexity of overlapping anti-GQ1b antibody syndromes and highlights the need for alternative diagnostic biomarkers in seronegative patients.
我们报告了一例罕见病例，一名56岁女性，尽管抗GQ1b、GM1、GD1b、GT1a和GT1b IgG抗体血清学检测呈阴性，但仍表现出米勒-费雪综合征（MFS）、比克斯特法夫脑干脑炎（BBE）和吉兰-巴雷综合征（GBS）的重叠特征。该患者在上呼吸道感染后出现了一系列神经功能缺损（眼肌麻痹、共济失调、四肢轻瘫和意识改变）。电生理研究证实为急性运动感觉轴索性神经病，而脑脊液分析显示蛋白细胞分离。双重静脉注射免疫球蛋白（IVIG）疗程和甲基强的松龙治疗导致部分恢复，患者在第76天能够独立行走。该病例强调了重叠抗GQ1b抗体综合征的复杂性，并突出了血清学阴性患者中替代诊断生物标志物的必要性。
