Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Anti-GQ1b IgG-negative case of overlapping FisherŐs and Gullain-Barré syndromes after Campylobacter jejuni (PEN 19) enteritis

Yasuaki Hayashi, M. D. 1) , Michiaki Koga, M. D. 2) , Masaki Takahashi, D. V. M. 3) , Arihiko Uchida, M. D. 1) and Nobuhiro Yuki, M. D. 4)

1)Department of Neurology, National Okayama Medical Center
2)Department of Clinical Neuroscience (Neurology), Yamaguchi University School of Medicine
3)Department of Microbiology, Tokyo Metropolitan Research Laboratory of Public Health
4)Department of Neurology, Dokkyo University School of Medicine

We described a 70-year-old woman with overlapping Fisher's syndrome (FS) and Guillain-Barré syndrome (GBS), from whom Campylobacter jejuni had been isolated. In typical FS as well as GBS with ophthalmoplegia and acute ophthalmoparesis without ataxia, serum anti-GQ1b IgG antibody often is detected and ophthalmoplegia is characterized by the predominant abducens palsy. This patient, however, showed marked oculomotor nerve disturbance. Serum anti-GQ1b IgG antibody was negative and IgG antibodies against GM1, GM1b, and GD1a were strongly positive. Although FS and overlap of FS/GBS have been reported to be associated with PEN 2 of C. jejuni, the isolate from our case belonged to PEN 19. C. jejuni serotype may be associated with clinical manifestations and anti-ganglioside antibody species.

(CLINICA NEUROL, 41: 801|804, 2001)
key words: Fisher's syndrome, Guillain-Barré syndrome, Campylobacter jejuni, anti-ganglioside antibody

(Received: 2-May-01)