Document Detail

An overlap case of Fisher syndrome and pharyngeal-cervical-brachial variant of Guillain-Barré syndrome.
MedLine Citation:
PMID:  22260976     Owner:  NLM     Status:  In-Data-Review    
A 29-year-old female developed diplopia, nasal voice and gait disturbance after an upper respiratory infection. On admission, she presented with bilateral external ophthalmoplegia, slight bilateral facial nerve palsy, dysarthria, dysphagia, cervical and brachial muscle weakness, ataxia and areflexia. She had serum anti-GT1a, anti-GQ1b and anti-galactocerebroside IgG antibodies. She was diagnosed with an overlap case of Fisher syndrome and pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. Intravenous immunoglobulin therapy was effective for the ophthalmoplegia and ataxia, but did not improve the bilateral facial nerve palsy and brachial muscle weakness. The facial nerve palsy clearly worsened despite improvement in other symptoms, and therefore high-dose intravenous methylprednisolone therapy was added. The distinct response to treatment may be caused by different activity, production, clearance and reactivity to intravenous immunoglobulin of the autoantibodies. The present case suggests that treatment response and patterns of recovery differ according to the causative anti-ganglioside antibodies.
Koji Shinoda; Hiroyuki Murai; Ken-Ichi Shibata; Shoko Samejima; Shuji Kaneto; Nobuyoshi Takashima; Kimihiro Tanaka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Rinshō shinkeigaku = Clinical neurology     Volume:  52     ISSN:  0009-918X     ISO Abbreviation:  Rinsho Shinkeigaku     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417466     Medline TA:  Rinsho Shinkeigaku     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  30-3     Citation Subset:  IM    
Department of Neurology, Iizuka Hospital.
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