title: Anti-GQ1b-Negative Miller Fisher Syndrome with Acute Areflexic Mydriasis and Cholinergic Supersensitivity.
abstract: Miller Fisher syndrome is a rare variant of Guillain-Barré syndrome and it is characterised by ophthalmoplegia, ataxia, and areflexia. Pupillomotor involvement occurs in approximately half of the patients with the disorder. The authors report a patient with acute areflexic mydriasis, external ophthalmoplegia, areflexia, and ataxia. Although the pupils were unreactive to light and near stimuli, administration of 0.1% pilocarpine resulted in marked miosis, suggesting cholinergic supersensitivity. Antibodies against GM1, GD1b, and GQ1b were negative. This is the first report of acute areflexic mydriasis with cholinergic supersensitivity in anti-GQ1b-negative Miller Fisher syndrome.
authors.affiliation: Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Özlem Kayım
authors.initials: ÖK
authors.lastname: Yıldız
authors.affiliation: Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Balaban
authors.affiliation: Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Özdemir
authors.affiliation: Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Ertuğrul
authors.initials: E
authors.lastname: Bolayır
authors.affiliation: Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Topaktas
keywords: Miller Fisher syndrome; anti-GQ1b; cholinergic supersensitivity; mydriasis