Mochizuki A, Ota K, Iijima M, Yamauchi T, Iwata M
Department of Neurology, Tokyo Women's Medical College.
Rinsho Shinkeigaku. 1996 May;36(5):675-9.
Miller Fisher syndrome (FS) is thought to be a variant of Gullain-Barré syndrome (GBS), both of which rarely relapse. We report a rare case of GBS that followed FS. A 38-year-old woman had ophthalmoplegia, ataxia and areflexia following an upper respiratory tract infection with a diagnosis of FS. Serum anti-GQ1b IgG antibody was found to be increased, but decreased through immunoadsorption as the neurological symptoms of the patient improved. She became completely asymptomatic three months after the onset of FS. Following a common cold two months later, however, she developed weakness of all four limbs and dysesthesia of hands and feet with albuminocytologic dissociation of cerebrospinal fluid, which was consistent with the diagnosis of GBS. Moreover, serum anti-GQ1b IgG antibody had increased again. Anti-GQ1b IgG antibody frequently becomes positive not only in FS but also GBS with ophthalmoplegia. However, the antibody was positive in this particular patient with GBS, even in the absence of ophthalmoplegia. This case suggests that anti-GQ1b IgG antibody might be a common pathogenesis of both FS and GBS.
米勒-费希尔综合征（FS）被认为是吉兰-巴雷综合征（GBS）的一种变异型，这两种疾病都很少复发。我们报告了一例罕见的继发于FS的GBS病例。一名38岁女性在患得上呼吸道感染后出现眼肌麻痹、共济失调和腱反射消失，诊断为FS。发现血清抗GQ1b IgG抗体升高，但随着患者神经症状的改善，通过免疫吸附法该抗体水平下降。FS发病三个月后她完全无症状。然而，两个月后患普通感冒后，她出现四肢无力和手脚感觉异常，脑脊液出现蛋白细胞分离，这与GBS的诊断相符。此外，血清抗GQ1b IgG抗体再次升高。抗GQ1b IgG抗体不仅在FS中，而且在伴有眼肌麻痹的GBS中也经常呈阳性。然而，在这名患有GBS的特定患者中，即使没有眼肌麻痹，该抗体也是阳性。该病例提示抗GQ1b IgG抗体可能是FS和GBS的共同发病机制。
