Anti-GQ1b-Negative Miller Fisher Syndrome with Acute Areflexic Mydriasis and Cholinergic Supersensitivity

• Published in: Neuro-ophthalmology (Amsterdam : Aeolus Press. 1980) Vol. 35; no. 1; pp. 40 - 42
• Main Authors: Y ld z, Özlem Kay m, Balaban, Hatice, Özdemir, Sibel, Bolay r, Ertu rul, Topaktas, Suat
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-02-2011; Taylor & Francis
• Subjects: Case Reports; anti-GQ1b; mydriasis; Miller Fisher syndrome; cholinergic supersensitivity
• ISSN: 0165-8107; 1744-506X
• DOI: 10.3109/01658107.2010.539761

Miller Fisher syndrome is a rare variant of Guillain-Barré syndrome and it is characterised by ophthalmoplegia, ataxia, and areflexia. Pupillomotor involvement occurs in approximately half of the patients with the disorder. The authors report a patient with acute areflexic mydriasis, external ophthalmoplegia, areflexia, and ataxia. Although the pupils were unreactive to light and near stimuli, administration of 0.1% pilocarpine resulted in marked miosis, suggesting cholinergic supersensitivity. Antibodies against GM1, GD1b, and GQ1b were negative. This is the first report of acute areflexic mydriasis with cholinergic supersensitivity in anti-GQ1b-negative Miller Fisher syndrome.