Atypical Miller Fisher syndrome associated with glutamate receptor antibodies.
The present study reports a young woman with acute ataxia, areflexia and ophthalmoplegia, accompanied by psychosis and involuntary movements (IVMs) from disease onset. Anti-GQ1b and anti-GT1a antibodies were detected allowing for a diagnosis of Miller Fisher syndrome (MFS). However, psychosis and IVMs are atypical MFS symptoms and often mimic symptoms of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Interestingly, the autoantibodies against full-length glutamate receptor-ε2 (GluRε2) and glutamate NR2B- and NR2A-containing heteromers (NR1/NR2) of NMDAR were also detected in the patient serum and cerebrospinal fluid. It was concluded that psychosis and IVMs in this patient were associated with autoantibodies against various GluRs.
Department of Neurology, Juntendo University, School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan. thatano@juntendo.ac.jp
Taku
T
Hatano
Yoshiaki
Y
Shimada
Ayako
A
Kono
Shin-ichiro
S
Kubo
Kazumasa
K
Yokoyama
Asako
A
Yoritaka
Toshiki
T
Nakahara
Yukitoshi
Y
Takahashi
Nobutaka
N
Hattori
D001323:Autoantibodies; D005260:Female; D006801:Humans; D019846:Miller Fisher Syndrome / Q000276:immunology*; D017470:Receptors, Glutamate / Q000276:immunology*; D055815:Young Adult
D001323:Autoantibodies; D017470:Receptors, Glutamate