title: Development of facial palsy during immunoadsorption plasmapheresis in Miller Fisher syndrome: a clinical report of two cases.
abstract: Immunoadsorption plasmapheresis (IAP) using a tryptophan linked gel column has been shown to effectively remove serum IgG anti-GQ1b antibody which may contribute to the pathogenesis of Miller Fisher syndrome. Two patients are reported on with Miller Fisher syndrome, who developed bilateral facial palsy during IAP using a tryptophan column, while ophthalmoplegia, ataxia, and, areflexia were improving. In these patients, the titre of anti-GQ1b antibodies was reduced. The IAP using a tryptophan column has a beneficial effect on Miller Fisher syndrome but may not inhibit the development of facial palsy. The mechanism of such a dissociated effect of IAP on Miller Fisher syndrome is discussed.
authors.affiliation: Department of Neurology, Kohnan Hospital, Sendai, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Chida
authors.forename: S
authors.initials: S
authors.lastname: Takase
authors.forename: Y
authors.initials: Y
authors.lastname: Itoyama
mesh_terms: D000368:Aged; D005158:Facial Paralysis / Q000209:etiology*; D005732:Gangliosides / Q000097:blood / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007163:Immunosorbent Techniques / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000628:therapy*; D009460:Neurologic Examination; D010956:Plasmapheresis / Q000009:adverse effects* / Q000379:methods; D012720:Severity of Illness Index; D014364:Tryptophan
chemical_list: D005732:Gangliosides; D007074:Immunoglobulin G; C039129:GQ1b ganglioside; D014364:Tryptophan