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Case Reports
. 2021 Sep-Oct;66(5):892-896.
doi: 10.1016/j.survophthal.2020.09.007. Epub 2020 Sep 30.

What did he eat?

Sara Rodrigo-Rey  1 , Consuelo Gutiérrez-Ortiz  2 , Silvia Muñoz  3 , Jesús Vicente Ortiz-Castillo  4 , R Michael Siatkowski  5
Affiliations
Case Reports

What did he eat?

Sara Rodrigo-Rey et al. Surv Ophthalmol. 2021 Sep-Oct.

Abstract

A 13-year-old boy reported acute horizontal binocular diplopia and headache. Ten days before these symptoms he suffered from a gastrointestinal infection. Ophthalmological examination revealed bilateral ophthalmoparesis and diffuse hyporeflexia. Magnetic resonance imaging of the brain was normal. Lumbar puncture revealed albumin-cytological dissociation. There were no anti-GQ1b antibodies, but serum anti-GM1 antibodies were detected. He received intravenous immunoglobulins and had fully recovered two weeks later. Miller Fisher syndrome and its atypical variants are uncommon in childhood; nevertheless, they should be considered in the differential diagnosis of bilateral acute ophthalmoparesis.

Keywords: Miller Fisher syndrome; acute ophthalmoparesis; anti-GQ1b antibody syndromes; antiganglioside antibodies; bilateral sixth nerve palsy; childhood diplopia.

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Figures

Fig. 1
Fig. 1
Ocular motility examination. Limitation of abduction in both eyes with mild internal ophthalmoplegia and ptosis in the left eye.
Fig. 2
Fig. 2
After treatment, there was complete recovery of extraocular motility.
See this image and copyright information in PMC

References

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