gq1b-ganglioside and Optic-Nerve-Diseases

We report a 38-year-old woman who developed what appeared to be Fisher syndrome associated with optic nerve involvement. One week after a common cold, she developed double vision and left facial palsy. Four days after the onset, she developed bilateral blurred vision, painful total ophthalmoplegia, and ataxic gait. Brain CT and MRI findings were normal. Her vision worsened but the optic fundi were normal. Serum anti-GQ 1 b antibody was elevated. She received steroid therapy at another hospital, and her vision, facial palsy and ocular pain improved. She was transferred to our hospital and we treated her by plasma exchange. She showed near complete recovery. Human optic and ocular nerves contain high amount of GQ 1 b. This may be a underlying mechanism for optic nerve involvement in Fisher syndrome. We thought that she had an atypical Fisher syndrome associated with optic nerve involvement.

Topics: Adult; Female; Gangliosides; Humans; Immunoglobulin G; Miller Fisher Syndrome; Optic Nerve Diseases

A 60-year-old woman with a 3-day history of ataxic gait, blurred vision, and upper extremity paresthesia was admitted to our hospital. She presented with severe visual disturbances (finger counting), ophthalmoplegia, neck weakness, and sensory ataxia. Serum anti-GQ1b antibody, anti-GM3 antibody, and anti-GD3 antibody were strongly positive, which might contribute to the pathogenesis. Since we suspected Guillain-Barré syndrome (GBS), intravenous immunoglobulin therapy (IVIg) and high-dose steroid therapy were administered; however, improvements in her visual acuity were minimal. Additional IVIg and high-dose steroid therapy resulted in limited visual acuity improvements. Therapeutic strategies for patients with GBS and refractory optic neuropathy remain controversial.

Topics: Autoantibodies; Biomarkers; Female; G(M3) Ganglioside; Gangliosides; Guillain-Barre Syndrome; Humans; Immunoglobulins, Intravenous; Methylprednisolone; Middle Aged; Optic Nerve Diseases; Pulse Therapy, Drug

Topics: Adult; Antibodies, Anti-Idiotypic; Benzimidazoles; Gangliosides; Humans; Male; Miller Fisher Syndrome; Optic Nerve Diseases

Fisher syndrome with optic neuropathy has been rarely reported. We report a 78-year-old Frenchman with Fisher syndrome. The patient complained of dizziness and bilateral blurred vision. His corrected visual acuity was 0.03 in the right eye, and 0.02 in the left eye. Deep tendon reflexes were absent. A few days later, bilateral complete external ophthalmoplegia appeared. Both pupils were dilated and pupillary reflexes were absent. Serum anti-GQlb antibodies and anti-GT1a antibodies were detected. After intravenous immunoglobulin treatments, all neurological symptoms including optic neuropathy and external ophthalmoplegia disappered except for pupillary dilatation associated with light-near dissociation. Tonic pupil indicated disorder of the peripheral nervous system.. Fisher syndrome may complicate optic neuropathy.

Topics: Aged; Biomarkers; Gangliosides; Humans; Immunoglobulin G; Immunoglobulins, Intravenous; Male; Miller Fisher Syndrome; Optic Nerve Diseases; Treatment Outcome