2022
DOI: 10.2169/internalmedicine.8416-21
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Acute Oropharyngeal Palsy Following Bilateral Adie's Tonic Pupils Associated with Anti-GT1a and GQ1b IgG Antibodies

Abstract: A 36-year-old man was admitted to our hospital with complaints of dysphagia and photophobia. A neurological examination showed oropharyngeal palsy and bilateral mydriasis with loss of light reflexes in the absence of external ophthalmoplegia. Bilateral pupils were supersensitive to pilocarpine 0.1%, which was compatible with Adie's tonic pupils. Serum IgG reacted with GQ1b, GT1a, GalNAc-GD1a, and GD3. Intravenous high-dose immunoglobulin therapy improved his neurological symptoms within three weeks. To our kno… Show more

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Cited by 3 publications
(2 citation statements)
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“…Isolated cranial nerve damage without ataxia reported previously includes cranial nerves III, IV, VI, VII, VIII ( 5 ), and IX ( 6 , 7 ); however, it is less reported in patients with anti-GQ1b antibodies in general. Herein, we report a case of a female patient diagnosed with GBS characterized only by the involvement of the facial and trigeminal nerves, who was positive for serum anti-GQ1b antibody secondary to M. pneumoniae infection.…”
Section: Introductionmentioning
confidence: 84%
“…Isolated cranial nerve damage without ataxia reported previously includes cranial nerves III, IV, VI, VII, VIII ( 5 ), and IX ( 6 , 7 ); however, it is less reported in patients with anti-GQ1b antibodies in general. Herein, we report a case of a female patient diagnosed with GBS characterized only by the involvement of the facial and trigeminal nerves, who was positive for serum anti-GQ1b antibody secondary to M. pneumoniae infection.…”
Section: Introductionmentioning
confidence: 84%
“…Anti-GQ1B antibodies are associated with Miller-Fisher syndrome, while anti-GQ1b and anti-GT1a IgG antibodies can be demonstrated in the acute oropharyngeal variant of GBS. However, apart from the association of Miller-Fisher syndrome with anti-GQ1B antibodies, the sensitivity and specificity of all antibodies for specific subtypes is low to moderate yield for clinical utility [38][39][40]. Considering that some patients are seronegative for anti-ganglioside antibodies, more studies are required to explain the role of anti-ganglioside antibodies in GBS, either as a cause or an epiphenomenon.…”
Section: The Molecular Diagnostic the Serum Biomarkersmentioning
confidence: 99%