Amyotrophic lateral sclerosis in a patient who recovered from Miller Fisher Syndrome: The role of GQ1b antibody revisited

Abstract

Miller Fisher Syndrome (MFS), a variant of Guillain Barre Syndrome (GBS), and amyotrophic lateral sclerosis (ALS) are two rare neuromuscular diseases that are usually unrelated. While ganglioside antibodies have a common relation with MFS and GBS, they have also been found in association, albeit less commonly, with ALS. A patient experiencing MFS and then ALS in tandem has never been documented. We discuss a case demonstrating these findings, with GQ1b elevated on both occasions. The pathophysiologic role of GQ1b is explored.

A case report of thrombocytopenic COVID-19 and Miller–Fisher syndrome on a concurrent chronic immune neuropathy

“…Interestingly, ganglioside antibodies, usually GM1, have been seen in ALS, with one case having been reported where ALS was diagnosed in a patient who had recovered from MFS. [14] One question that remains in our patient is why he still has +1 brachioradialis reflexes. One theory is that he was possibly hyperreflexic from an underlying myelopathy due to his cervical stenosis.…”