A rare Anti-GQ1b antibody syndrome- ataxic variant of Guillain Barre syndrome

Miller Fisher syndrome (MFS) or Fisher syndrome is an uncommon variant of Guillain Barre syndrome (GBS) and is defined by triad of ophthalmoplegia, cerebellar-like ataxia and areflexia. GBS variants with ophthalmoplegia are characteristically associated with anti-GQ1b antibody. Variants associated with this antibody are Bickerstaff brainstem encephalitis, acute ophthalmoplegia without ataxia and Guillain Barre syndrome with ophthalmoplegia. There are other limited variants of Miller Fisher syndrome which lacks one or two components of the triad. We report a case of anti-GQ1b antibody syndrome with cerebellar like ataxia and areflexia without ophthalmoplegia- Ataxic variant of GBS. Even though multiple combined antiganglioside antibodies are described in MFS, simultaneous presence of GQ1b, GD1b and GM1 antibody is exceedingly infrequent.