A 19-year-old man presented with acute-onset diplopia and left ptosis. Neurological examination was notable for left ophthalmoparesis mimicking oculomotor nerve palsy, but no ataxia or areflexia/hyporeflexia. The patient’s blood examination, cerebrospinal fluid examination, and brain magnetic resonance imaging revealed unremarkable findings. Serological tests detected anti-GQ1b IgG antibodies, and we suspected a variant form of Miller Fisher syndrome. The patient’s ophthalmoparesis began to improve 10 days after onset without any medication, and completely recovered 7 weeks after onset. Anti-GQ1b-antibody-associated disorder should be considered in patients with symptoms mimicking unilateral oculomotor nerve palsy.
靖記 et al. (Sun,) studied this question.