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Han, Oh, and Park: Clinical Features of Acute Opthalmoplegia Associated with Anti-GQ1b Antibody
Original Article

Journal of the Korean Ophthalmological Society 2019; 60(12): 1284-1289.

Published online: 17 December 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1284

Clinical Features of Acute Opthalmoplegia Associated with Anti-GQ1b Antibody

Sun Hyup Han, MD, Sei Yeul Oh, MD, Kyung-Ah Park, MD

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address reprint requests to Kyung-Ah Park, MD. Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: 82-2-3410-3562, Fax: 82-2-3410-0074, lethe22@hanmail.net

Received 28 June 2019       Revised 19 July 2019       Accepted 6 December 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the clinical features of acute ophthalmoplegia associated with anti-GQ1b antibody in the Republic of Korea.

Methods

From January 2011 to July 2018, we retrospectively reviewed the medical records of all patients who tested positive for anti-GQ1b antibody, and who had been concurrently diagnosed with acute ophthalmoplegia at a tertiary hospital in the Republic of Korea. Ophthalmic and neurological features were carefully reviewed. Laboratory results including ganglioside antibody panels and treatment outcomes were analyzed.

Results

Thirty-three patients were enrolled in the study and 8 (24%) of them showed pure Miller-Fisher syndrome with all three cardinal symptoms of ophthalmoplegia, ataxia, and areflexia. One patient (3%) showed ophthalmoplegia, areflexia, and pharyngeal- cervical-brachial weakness without ataxia and 2 patients (6%) showed only ophthalmoplegia and pharyngeal-cervical- brachial weakness without ataxia and areflexia. Twenty-two patients (67%) showed only ophthalmoplegia without any other neurological symptom. Early immunosuppressant treatment was used to treat 17 patients, and observation only was conducted as the initial treatment for 16 patients (48.5%). Twenty-four patients (72.7%) showed improvement and 9 patients showed persistent strabismus and diplopia. The average duration until recovery was 2.52 ± 2.11 months.

Conclusions

The symptoms of acute ophthalmoplegia associated with anti-GQ1b antibody can manifest in various forms that overlap with clinical features of demyelinating neuropathy, so it is important to recognize such characteristics when treating acute ophthamoplegia.

Keywords: Acute ophthalmoplegia, Anti-GQ1b antibody, Areflexia, Ataxia, Atypical Miller-Fisher syndrome

Figures and Tables

Table 1

Clinical manifestations of Miller-Fisher syndrome

jkos-60-1284-i001

Values are presented as number (%).

IVIG = intravenous immunoglobulin; IV = intravenous.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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