Acute Ophthalmoplegia with Tonic Pupils

Huang, Zei-Lun; Lin, Kuan‐Hung; Liu, An-Bang; Funakoshi, Kengo; Sheu, Min-Muh; Tsai, Rong‐Kung

doi:10.1080/01658100701647548

Cited by 1 publication

(1 citation statement)

References 28 publications

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“…Although symmetric bilateral ophthalmoplegia is the rule, ocular motility disorders may begin asymmetrically and quickly progress to complete ophthalmoplegia. Internal ophthalmoplegia or tonic pupils are commonly present on examination [29,30]. This author personally observed denervation supersensitivity in both pupils of one patient, just as Huang observed [30].…”

Section: Clinical Featuresmentioning

confidence: 77%

Neuro-ophthalmology and the anti-GQ1b antibody syndromes

Saul

2009

Curr Neurol Neurosci Rep

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The discovery of the association of the anti-GQ1b IgG antibody with the postinfectious clinical syndromes of ophthalmoplegia, ataxia, and areflexia helped house the phenotypes of the Miller Fisher syndrome (MFS), atypical MFS, Guillain-Barré syndrome with ophthalmoplegia, and Bickerstaff's brainstem encephalitis under one roof. The neuro-ophthalmologic signs classically predominate and may vary from case to case, but they maintain clinically recognizable patterns that assist with the diagnosis. The identification of a common lipopolysaccharide on the plasma membrane in human cranial and peripheral nerves at the GQ1b epitope and on infectious particles of bacteria and viruses (ie, Campylobacter jejuni) demonstrates molecular mimicry. The high frequency of oculomotor dysfunction is partially explained by the tissue ganglioside concentration and distribution and the attraction of antibody-stimulating complement activation. Current experimental treatment targets antibody removal and neutralization and prevents membrane attack complex formation through deactivation of complement. This article aims to bring together the historically disparate opinions on the origins of these syndromes as either a purely peripheral nervous system or central nervous system dysfunction, highlight the clinical neuro-ophthalmologic signs, discuss some of the biology of the anti-GQ1b antibody, and review imaging abnormalities and treatment of this fascinating disorder.

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Section: Clinical Featuresmentioning

confidence: 77%

Neuro-ophthalmology and the anti-GQ1b antibody syndromes

Saul

2009

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

show abstract

Acute Ophthalmoplegia with Tonic Pupils

Cited by 1 publication

References 28 publications

Neuro-ophthalmology and the anti-GQ1b antibody syndromes

Neuro-ophthalmology and the anti-GQ1b antibody syndromes

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