Unilateral Abducens Nerve Palsy as an Early Feature of Multiple Mononeuropathy Associated with Anti-GQ1b Antibody.

Patients with anti-GQ1b antibody syndrome show various combinations of ophthalmoplegia, ataxia, areflexia, or altered sensorium as clinical features. We describe herein a unique case with unilateral abducens nerve palsy as an early feature of multiple mononeuropathy involving dysfunctions of the inferior dental plexus and the ulnar nerve, which was thought to be associated with anti-GQ1b antibody. A 27-year-old man presented with acute-onset diplopia. He subsequently experienced numbness not only in the right lower teeth and gums but also on the ulnar side of the left hand. Neurological examinations revealed dysfunctions of the right abducens nerve, the right inferior dental plexus, and the left ulnar nerve, suggesting multiple mononeuropathy. Serum anti-GQ1b antibody was positive. This is a rare case report of a patient with unilateral abducens nerve palsy as an early feature of multiple mononeuropathy associated with anti-GQ1b antibody. We suggest that anti-GQ1b antibody syndrome should be taken into consideration as a differential diagnosis of acute multiple mononeuropathy if ophthalmoplegia is present unilaterally.

[A single administration of morphine suppresses the reduction of the systemic immune activity caused by acute inflammatory pain in rats].

BACKGROUND: Pain accompanying various diseases as well as invasion and postoperative pain reduce immune activities, and affect the prognosis of diseases and recovery after surgery (metastasis and relapse). While, some anesthetics and synthetic narcotics used to reduce pain are reported to suppress immune activities depending on the kind of medication and the dosing strategy. However, it is not clear how the single use of narcotics affects the immune activity at the acute stage of severe inflammatory pain. This study is undertaken to examine the effect of a single administration of morphine on the splenic NK cell activity in the acute inflammatory pain model rats. METHODS: Rats received a 50 microl s.c. injection of 4% formaldehyde into the plantar surface of the right hindpaw. The spleen was removed 2 hours later and the splenic NK-cell activity was measured by 51Cr release assay. RESULTS: Acute pain significantly reduced the splenic NK cell activity, but the single administration of morphine suppressed its reduction. CONCLUSIONS: It was indicated that the single administration of morphine could suppress the reduction of the systemic immune activity caused by acute inflammatory pain.