[Variable and recurrent ptosis and ophthalmoplegia in chronic polyradiculoneuritis]

Fluctuating ptosis and diplopia are typical features of myasthenia gravis. This report describes four patients who developed these symptoms and in whom the investigations have demonstrated typical features of chronic inflammatory polyradiculoneuropathy. Ptosis and ophtalmoplegia were in most the cases unilateral and were sometimes painful. The evolution was fluctuant with episodic exacerbations. These unusual clinical features have responded like other features of CIDP to corticosteroids or to intravenous immune globulin but relapses are always possible. We did not find in the serum of three patients anti-GQ1b IgG antibodies as previously found in Miller-Fisher syndrome or in Guillain-Barré syndrome associated with ophtalmoplegia. Considering these results, on can argue that other immune mechanisms are involved.