Abstract
Introduction Ophthalmoplegia without ataxia, areflexia, or both has been designated as atypical Miller Fisher syndrome or acute ophthalmoplegia (AO) [1]. In such patients, the determination of the presence of serum antibodies against ganglioside GQ1b is useful for confirming the diagnosis [2].
Approximately 5% of North American and European patients with Guillain-Barre syndrome (GBS) have Fisher syndrome (FS), whereas in Eastern Asia, the proportion of patients with FS is 25-30% [3]. Most cases of FS are characterized by external ophthalmoplegia.
However, in a fairly large group of patients with antibodies against GQ1b internal ophthalmoplegia was found in 163 (35%) patients in the FS subgroup [4]. A patient presented to our hospital with acute onset of bilateral internal and external ophthalmoplegia, without ataxia or pain.
Finally, high titers of antibodies against GQ1b provided confirmation of correct diagnosis. The purpose of this report is to describe the case.
Case Report