Teaching Video NeuroImage: Near complete ophthalmoplegia in GQ1b antibody-positive Miller Fisher
Video and MRI correlation
David T. Hsieh, MD,
Rani Singh, MD,
Nassim Zecavati, MD and
Ben Emmanuel, DO
From the Department of Neurology (D.T.H., R.S., N.Z.), Children’s National Medical Center; and Department of Neurology (B.E.), Georgetown University Hospital, Washington, DC.
Address correspondence and reprint requests to Dr. David T. Hsieh, Fellow, Department of Neurology, Children’s National Medical Center, 111 Michigan Ave, NW, Washington, DC 20010 dhsieh{at}cnmc.org
An 8-year-old boy developed near complete ophthalmoplegia (videoand figure 1), sparing the pupils, with mild gait ataxia, andareflexia. Miller Fisher syndrome was diagnosed after high titersof anti-GQ1b IgG, which are highly disease specific,1 were foundin the serum. Nerve conduction, laboratory, and Tensilon testingwas not suggestive of alternative diagnoses. MRI in Miller Fishercan show cranial nerve enhancement,2 and in this patient revealedbilateral gadolinium enhancement of cranial nerve III (figure 2).IVIg was given with improvement seen within days. We presenta case of near complete ophthalmoplegia from Miller Fisher withvideo and MRI correlation.
Disclaimer: The views expressed in this article are those ofthe authors and do not reflect the official policy or positionof the United States Air Force, Department of Defense, or theUS Government.
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