Two cases of influenza with impaired ocular movement

Migita, Makoto; Matsumoto, Tae; Fujino, Osamu; Takaishi, Yasuko; Yuki, Nobuhiro; Fukunaga, Yoshitaka

doi:10.1053/ejpn.2001.0470

Cited by 17 publications

(9 citation statements)

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“…This is also consistent with some anecdotal cases of GBS or GBS-related diseases that occurred after influenza, although these cases were mainly reported in pediatric patients [29,30]. However, our data reveal that cases of influenza-related GBS occur relatively infrequently, and this may explain why no previous study has yet proved a direct link between influenza and GBS.…”

Section: Discussionsupporting

confidence: 92%

Guillain‐Barré Syndrome and Influenza Virus Infection

et al. 2009

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Section: Discussionsupporting

confidence: 92%

Guillain‐Barré Syndrome and Influenza Virus Infection

et al. 2009

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“…The second case was in a ten-year-old female who developed extraocular muscle weakness in association with lower leg paresis, again in the setting of elevated influenza A antibodies. The CSF studies revealed a profile that was consistent with a diagnosis of Guillain-Barré syndrome 6 . The third case was in five-year-old boy who developed ptosis and paresis of the superior rectus muscle on the right side, in association with a positive influenza A complement binding reaction.…”

Section: Discussionmentioning

confidence: 53%

“…A case of isolated hypoglossal palsy following immunization with bivalent killed influenza (A and B) has been reported in the literature 5 . Furthermore, there have been three cases of impaired ocular movements associated with influenza A infection 6,7 . The first case involved a three-year-old female who developed bilateral ptosis and was found to have elevated influenza A antibodies suggestive of infection.…”

Section: Discussionmentioning

confidence: 99%

Cranial Nerve Palsies Associated with Influenza B

McCombe

Narayansingh

Jhamandas

2009

Can. j. neurol. sci.

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Influenza B is a relatively common cause of influenza worldwide. Despite this, the recognition of neurological complications is very low. We report a case of isolated third and fourth cranial nerve palsies associated with influenza B infection, and to our knowledge, this is the first such reported case. CASE REPORTThe patient is a 42-year-old man who presented to the emergency department with a one day history of diplopia, left eyelid droopiness and headache, preceded by a two day history of cough, coryza, myalgias, and fever. He described the headache as dull in quality, moderate in severity, and localized behind his left eye. There was no alteration in level of consciousness and no other focal neurological symptoms. He was an otherwise healthy man and was on no medications. He denied any risk factors for HIV. He had recently travelled to South Africa four months previously where he spent two weeks hunting in remote areas of the country.Initial examination revealed he was febrile with a temperature of 39.3˚C, was tachycardic with a heart rate of 120 BPM and normotensive. Chest was clear on auscultation and there was no lymphadenopathy. He was not encephalopathic and had no nuchal rigidity. He had marked left eye ptosis but no evidence of conjunctival injection, edema, or discharge. His pupils were asymmetrical, the left being significantly larger than the right, although both were reactive to light. On primary gaze, he had an exotropia of his left eye. On extraocular movement testing, his left eye would abduct with left gaze but would not reach midline with right gaze. There were no discernible vertical eye movements noted in his left eye. There was no intortion noted in his left eye on attempted downgaze. Eye movements were full in his right eye. There was no sensory disturbance to his face. The remainder of his neurological exam was normal. We considered his findings to be consistent with complete left third and fourth nerve palsies.Initial laboratory investigations revealed no abnormalities other than a moderately low lymphocyte count at 0.5 x 10 9 cells/L. Magnetic resonance image of the brain with gadolinium enhancement and 3D time of flight MRA were normal. The CSF studies were normal with a WBC count of 1 x 10 6 cells/L, a RBC count of 2 x 10 6 cells/L, protein of 0.28 g/L and glucose of 3.7 mmol/L. A nasopharyngeal swab (direct fluorescent antibody) was positive for influenza B and negative for influenza A, parainfluenza and RSV. Acute and convalescent influenza serologies were not obtained. Treatment with oral oseltamivir was initiated.

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“…However, a large prospective case-control serological study showed the associated infective agents to remain unknown in the majority of cases (2). Recently, the cases of a 17-month-old boy with MFS following a pandemic H1N1 influenza A infection (18), a 39-year-old woman with acute ophthalmoparesis following influenza A infection (19), and two children with an impaired ocular movement (20) following influenza A infection were reported. However, antiGQ1b antibodies were not detected (18) or not demonstrated (19,20) in their serum.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the cases of a 17-month-old boy with MFS following a pandemic H1N1 influenza A infection (18), a 39-year-old woman with acute ophthalmoparesis following influenza A infection (19), and two children with an impaired ocular movement (20) following influenza A infection were reported. However, antiGQ1b antibodies were not detected (18) or not demonstrated (19,20) in their serum. There has been no previous report of an adult patient in whom the presence of antiGQ1b antibodies was confirmed showing MFS associated with influenza A infection.…”

Section: Discussionmentioning

confidence: 99%

Miller Fisher Syndrome Associated with Influenza A Infection

et al. 2012

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A 36-year-old, previously healthy man presented with Miller Fisher syndrome (MFS) five days after he was diagnosed with an influenza A infection by a rapid antigen test. He had not received any recent vaccinations. He had no loss of consciousness. Bilateral ophthalmoplegia, blepharoptosis, areflexia, and ataxic gait were noted. One week after treatment with intravenous immunoglobulin, his ophthalmoplegia, blepharoptosis, and ataxic gait had gradually improved, and his deep tendon reflexes returned. Anti-GQ1b IgG antibodies were detected in his serum. There has been no previous report of postinfectious MFS following confirmed an influenza A infection in an adult.

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Two cases of influenza with impaired ocular movement

Cited by 17 publications

References 0 publications

Guillain‐Barré Syndrome and Influenza Virus Infection

Guillain‐Barré Syndrome and Influenza Virus Infection

Cranial Nerve Palsies Associated with Influenza B

Miller Fisher Syndrome Associated with Influenza A Infection

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