title: Anti-GQ1b antibody syndrome presenting as acute isolated bilateral ophthalmoplegia: Report on two patients and review of the literature.
abstract: BACKGROUND
  Miller Fisher syndrome (MFS) is an acute polyradiculoneuritis regarded as an uncommon clinical variant of Guillain-Barré syndrome (GBS). MFS is characterized by the acute onset of the clinical triad of ophthalmoplegia, cereballar ataxia and areflexia. Atypical forms of MFS presenting as isolated ophthalmoplegia without ataxia have been rarely described, mostly in adults.
  
  
  METHODS
  We present two cases of acute isolated bilateral ophthalmoplegia in childhood, both occurring shortly after Campylobacter jejuni enteritis. Serum analysis of anti-ganglioside antibodies revealed elevated levels of anti-GQ1b IgG and IgM. We observed in both children complete spontaneous resolution several weeks after onset.
  
  
  CONCLUSIONS
  The cases of the two patients confirm the rare but possible occurrence of atypical MFS in young children a few weeks after gastrointestinal infection. Identification of high levels of anti-GQ1b antibodies in the serum may help confirm the diagnosis of MFS even when its clinical presentation is incomplete.
authors.affiliation: Department of Paediatrics, Centre Hospitalier Universitaire Saint-Pierre (U.L.B.), Rue Haute 322, 1000 Brussels, Belgium. Electronic address: francois.guisset@ulb.ac.be.
authors.forename: François
authors.initials: F
authors.lastname: Guisset
authors.affiliation: Department of Paediatrics, Centre Hospitalier Universitaire Saint-Pierre (U.L.B.), Rue Haute 322, 1000 Brussels, Belgium.
authors.forename: Christine
authors.initials: C
authors.lastname: Ferreiro
authors.affiliation: Department of Paediatric Neurology, Centre Hospitalier Universitaire Saint-Pierre (U.L.B.), Rue Haute 322, 1000 Brussels, Belgium.
authors.forename: Serge
authors.initials: S
authors.lastname: Voets
authors.affiliation: Department of Paediatrics, Centre Hospitalier Universitaire Saint-Pierre (U.L.B.), Rue Haute 322, 1000 Brussels, Belgium.
authors.forename: Julie
authors.initials: J
authors.lastname: Sellier
authors.affiliation: Laboratory of Immunology, IRISLab, Centre Hospitalier Universitaire Brugmann (U.L.B.), Place Van Gehuchten 4, 1020 Brussels, Belgium.
authors.forename: France
authors.initials: F
authors.lastname: Debaugnies
authors.affiliation: Laboratory of Immunology, IRISLab, Centre Hospitalier Universitaire Brugmann (U.L.B.), Place Van Gehuchten 4, 1020 Brussels, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Corazza
authors.affiliation: Department of Paediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola (U.L.B.), Avenue Crocq 15, 1020 Brussels, Belgium.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Deconinck
authors.affiliation: Department of Paediatric Neurology, Centre Hospitalier Universitaire Saint-Pierre (U.L.B.), Rue Haute 322, 1000 Brussels, Belgium; Department of Paediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola (U.L.B.), Avenue Crocq 15, 1020 Brussels, Belgium.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Prigogine
mesh_terms: D000208:Acute Disease; D000906:Antibodies / Q000097:blood; D002169:Campylobacter Infections / Q000150:complications; D016123:Campylobacter jejuni; D002648:Child; D002675:Child, Preschool; D005732:Gangliosides / Q000276:immunology*; D005759:Gastroenteritis / Q000150:complications; D006801:Humans; D008297:Male; D019846:Miller Fisher Syndrome / Q000150:complications* / Q000175:diagnosis*; D009886:Ophthalmoplegia / Q000209:etiology*
chemical_list: D000906:Antibodies; D005732:Gangliosides; C039129:GQ1b ganglioside
keywords: Acute ophthalmoplegia; Anti-GQ1b antibody; Atypical Miller Fisher syndrome; Children