J Korean Ophthalmol Soc > Volume 60(12); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(12):1284-1289.
DOI: https://doi.org/10.3341/jkos.2019.60.12.1284    Published online December 15, 2019.
Clinical Features of Acute Opthalmoplegia Associated with Anti-GQ1b Antibody.
Sun Hyup Han, Sei Yeul Oh, Kyung Ah Park
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. lethe22@hanmail.net
항GQ1b 항체 양성인 급성 눈근육마비의 임상양상
한선협 · 오세열 · 박경아
성균관대학교 의과대학 삼성서울병원 안과학교실
Correspondence:  Kyung-Ah Park, MD
Email: lethe22@hanmail.net
Received: 28 June 2019   • Revised: 19 July 2019   • Accepted: 6 December 2019
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.
Key Words: Acute ophthalmoplegia;Anti-GQ1b antibody;Areflexia;Ataxia;Atypical Miller-Fisher syndrome


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