[Recurrent Miller Fisher syndrome and anti-GQ1b antibodies].
BACKGROUND
Miller-Fisher syndrome is defined by the triad: ophthalmoplegia, ataxia and areflexia. This rare entity is generally regarded as a variant of the Guillain-Barré syndrome, although neurophysiological patterns differ. In the acute phase of the disease, sera of affected patients contain high titers of antiganglioside anti-GQ1b, which is a specific marker. Recurrences are exceptional.


METHODS
We report the case of a man with three recurrences of Miller-Fisher syndrome within 16 years. Anti-GQ1b antibody titers were elevated during an episode, decreasing but not completely and vanishing 2 years later. Intravenous human immunoglobulin treatment probably accelerated improvement at the two last episodes.


CONCLUSIONS
Some experimental and immunohistochemical data from the literature argue for a probable direct pathogenic role of antibodies against GQ1b ganglioside in this syndrome. This should be a rationale for the use of immunomodulating treatments.
Riche
G
G
Service de neurologie A, hôpital neurologique et neurochirurgical Pierre-Wertheimer, Lyon, France.
Caudie
C
C
Vial
C
C
Bourrat
C
C
D000906:Antibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005732:Gangliosides / Q000276:immunology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000097:blood / Q000276:immunology* / Q000628:therapy; D012008:Recurrence
D000906:Antibodies; D015415:Biomarkers; D005732:Gangliosides; D016756:Immunoglobulins, Intravenous; C039129:GQ1b ganglioside
Syndrome de Miller-Fisher à rechutes et anticorps anti-GQ1b.