A case of anti-GA1 antibody-positive Fisher syndrome with elevated tau protein in cerebrospinal fluid

Oyazato, Yoshinobu; Shiihara, Takashi; Kusunoki, Susumu; Adachi, Masao; Ohnishi, Noriko; Taniguchi, Hiroaki; Nishiyama, Atsushi; Watanabe, Aika; Kobayashi, Mitsuro; Kamioka, Ichiro

doi:10.1016/j.braindev.2011.06.007

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…For example, Oyazato and colleagues reported a recent atypical persistent case of Miller Fisher syndrome following Campylobacter enterocolitis where the patient had anti-GA1 antibody in his serum, but not anti-GQ1b and anti-GT1a (198). Further work is required to investigate the etiology and epidemiology of Campylobacter-associated Miller Fisher syndrome and the ability of Campylobacter species other than C. jejuni to trigger this disease.…”

Section: Miller Fisher Syndromementioning

confidence: 99%

Global Epidemiology of Campylobacter Infection

et al. 2015

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SUMMARY Campylobacter jejuni infection is one of the most widespread infectious diseases of the last century. The incidence and prevalence of campylobacteriosis have increased in both developed and developing countries over the last 10 years. The dramatic increase in North America, Europe, and Australia is alarming, and data from parts of Africa, Asia, and the Middle East indicate that campylobacteriosis is endemic in these areas, especially in children. In addition to C. jejuni , there is increasing recognition of the clinical importance of emerging Campylobacter species, including Campylobacter concisus and Campylobacter ureolyticus . Poultry is a major reservoir and source of transmission of campylobacteriosis to humans. Other risk factors include consumption of animal products and water, contact with animals, and international travel. Strategic implementation of multifaceted biocontrol measures to reduce the transmission of this group of pathogens is paramount for public health. Overall, campylobacteriosis is still one of the most important infectious diseases that is likely to challenge global health in the years to come. This review provides a comprehensive overview of the global epidemiology, transmission, and clinical relevance of Campylobacter infection.

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Section: Miller Fisher Syndromementioning

confidence: 99%

Global Epidemiology of Campylobacter Infection

et al. 2015

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Serum and CSF biomarkers in acute pediatric neurological disorders

Shiihara

Miyake

Izumi

et al. 2014

Brain and Development

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Alternating ptosis associated with asialo-GM1 and GD1b antibodies

Liao

Kamiya-Matsuoka

Fang

et al. 2016

International Journal of Neuroscience

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Miller Fisher syndrome (MFS), variant of acute inflammatory demyelinating polyradiculoneuropathy, is recognized as clinical triad (ophthalmoplegia-ataxia-areflexia). Ganglioside antibodies play an important role in the pathogenesis of acute polyradiculoneuropathy including MFS. To our knowledge, there has been no report of MFS presenting with atypical alternating ptosis or with concurrent elevation of serum GD1 and asialo-GM1 antibody titers, and negative titers of GQ1b antibody such as our patient. Our objective is to report MFS with unusual symptoms and to share our diagnostic approach. We report a rare case of MFS presenting with alternating eyelid ptosis, paresthesia, and ataxia after a respiratory infection. Initial neurological examination revealed left eyelid ptosis, hyporeflexia, positive Romberg sign, and ataxia. The ice pack test was negative. Three days later, contralateral ptosis was observed, associated with areflexia and worsened ataxia. However, there was significant improvement of the previous left eyelid ptosis. Serology revealed elevated asialo-GM1 and GD1b antibodies. Acetylcholine receptor antibodies were negative. Cerebral spinal fluid revealed elevated IgG index. Nerve conduction studies (NCS) performed four days after the onset of symptoms showed normal nerve conduction velocities and F-waves, and absent bilateral H-reflexes. Repetitive nerve stimulation (3 Hz) showed no decrement of compound muscle action potentials. Trial with a single dose of pyridostigmine showed no clinical improvement. The symptoms resolved without intervention. NCS 18 days after onset of symptoms showed mildly prolonged F-waves and absent H-reflexes. This case highlights an atypical presentation of MFS and raises the awareness of a rare autoantibody associated with it.

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A case of anti-GA1 antibody-positive Fisher syndrome with elevated tau protein in cerebrospinal fluid

Cited by 4 publications

References 12 publications

Global Epidemiology of Campylobacter Infection

Global Epidemiology of Campylobacter Infection

Serum and CSF biomarkers in acute pediatric neurological disorders

Alternating ptosis associated with asialo-GM1 and GD1b antibodies

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