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Bilateral abducens nerve paresis associated with anti-GQ1b IgG antibody
1Department of Neurology, Kanazawa University School of Medicine, Kanazawa, Ishikawa, Japan. sato-k@pop.m.kanazawa-u.ac.jp
Insights
Two boys with bilateral abducens nerve paresis showed increased serum anti-GQ1b IgG antibody. This suggests the antibody may cause this condition, which resolved spontaneously.
Area of Science:
- Ophthalmology
- Neurology
- Immunology
Background:
- Bilateral abducens nerve paresis can cause significant visual disturbances.
- The role of specific autoantibodies in cranial nerve palsies is an area of ongoing research.
Observation:
- Two pediatric cases presented with acute onset of diplopia following infectious symptoms.
- Clinical examination revealed isolated bilateral abducens nerve paresis in both patients.
- Routine investigations and MRI were unremarkable, but serum anti-GQ1b IgG antibody titers were elevated.
Findings:
- Elevated serum anti-GQ1b IgG antibody levels were detected in both patients.
- The presence of these antibodies correlated with the development of bilateral abducens nerve paresis.
- Symptoms and neurological deficits resolved spontaneously within six weeks.
Implications:
- Serum anti-GQ1b IgG antibodies may play a causative role in certain cases of bilateral abducens nerve paresis, particularly post-infectious.
- This finding expands the understanding of GQ1b antibody-associated disorders.
- Further research is warranted to elucidate the precise mechanisms and diagnostic utility of GQ1b antibodies in neuro-ophthalmological conditions.
Purpose:
To describe two cases with bilateral abducens nerve paresis associated with serum anti-GQ1b IgG antibody.
Methods:
Case reports.
Results:
Two boys, aged 12 and 10 years, experienced acute onset of diplopia after preceding symptoms and signs of infection. In both boys, examination showed only bilateral abducens nerve paresis. Although routine laboratory data and magnetic resonance imaging demonstrated no pathologic findings, titer of anti-GQ1b IgG antibody in the sera of both patients was increased. Diplopia and signs of bilateral abducens nerve paresis disappeared in 6 weeks without any specific treatment.
Conclusion:
The anti-GQ1b IgG antibody in the sera of both patients probably contributed to the bilateral abducens nerve paresis.