title: A rare case of complete bilateral ophthalmoplegia and ptosis.
abstract: We describe the case of an 85-year-old gentleman admitted with bilateral ptosis and complete bilateral ocular paralysis. Initial differential diagnoses included myasthenia gravis, diabetic cranial neuropathy, an ischaemic event and possible occult neoplasm. Investigations did not support any of the differentials and Miller Fisher syndrome (MFS) was considered. Anti-GQ1b IgG antibody was positive, supporting the possibility of anti-ganglioside syndrome. This gentleman was treated with intravenous immunoglobulin (IVIG) and made a full recovery.
authors.affiliation: Medicine, Calderdale and Huddersfield NHS Foundation Trust, Calderdale Royal Hospital Salterhebble, Halifax, West Yorkshire HX30PW, UK.
authors.forename: Daniel John
authors.initials: DJ
authors.lastname: Hall
authors.forename: Talal
authors.initials: T
authors.lastname: Bazaraa
mesh_terms: D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001763:Blepharoptosis / Q000175:diagnosis / Q000209:etiology*; D005732:Gangliosides / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007155:Immunologic Factors / Q000008:administration & dosage; D008297:Male; D019846:Miller Fisher Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D005732:Gangliosides; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; C039129:GQ1b ganglioside
keywords: Anti-GQ1b antibody; Miller Fisher syndrome; bilateral ptosis; older people; ophthalmoparesis