D'Angelo KM, Williams J, Wu L. Anti-GQ1b Antibody Syndrome Presented as Locked-In Syndrome: A Rare Case Report.
Cureus 2023;
15:e49866. [PMID:
38170042 PMCID:
PMC10760350 DOI:
10.7759/cureus.49866]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Anti-GQ1b antibodies are considered a hallmark of Miller-Fisher syndrome (MFS), a rare variant of Guillain-Barré syndrome (GBS). The typical clinical presentation of MFS includes ophthalmoplegia, ataxia, and areflexia. Here, we present an unusual case of a 65-year-old man with acute-onset quadriplegia and bulbar weakness resembling locked-in syndrome. Imaging studies did not show structural lesions as a cause for his clinical symptoms. Nerve conduction studies showed severe axonal sensory-motor polyneuropathy. Serum studies were all negative except for a positive anti-GQ1b antibody. He was treated with plasmapheresis as MFS, with a quick improvement in muscle strength. Our case report provided further information on the clinical variation of anti-GQ1b syndrome. Physicians should pay more attention to unusual presentations of anti-GQ1b syndrome because, when it is recognized early with prompt treatment, patients are expected to have a good recovery.
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