RESUMEN
We report on three patients who presented a rare, uniform clinical syndrome consisting of ocular flutter and truncal ataxia. In all patients the symptoms followed an upper respiratory infection and resolved without sequelae within a few weeks. Previous reports have emphasized the apparent relationship of this entity to infectious disease, but the infectious agent remained uncertain. In one patient we could find a significant rise in antibody titres to enterovirus. We are not aware of any other similar documented case.
Asunto(s)
Ataxia/virología , Nistagmo Patológico/virología , Infecciones del Sistema Respiratorio/complicaciones , Adulto , Anticuerpos Antivirales/sangre , Ataxia/inmunología , Ataxia/fisiopatología , Electronistagmografía , Infecciones por Enterovirus/complicaciones , Femenino , Humanos , Nistagmo Patológico/inmunología , Nistagmo Patológico/fisiopatología , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/virologíaRESUMEN
IgA, IgG, and IgM antibodies against ganglioside GM 1 were investigated in sera of 15 patients with Guillain-Barré syndrome (GBS), as compared with healthy controls. Significantly raised titers were found in 4 patients who showed persisting weakness due to muscle wasting (3 patients) or due to the development of a chronic relapsing form of GBS (1 patient) after a follow up period of 1 year. By contrast, only 1 out of 11 anti-GM 1 seronegative patients showed persisting muscle wasting. In 1 patient with GBS following Campylobacter jejuni enteritis an IgA anti-GM 1 immune response was found to predominate, suggesting that this immune response may be due to crossreactivity between GM 1 and Campylobacter antigens. We conclude that elevated antibody titers against ganglioside GM 1 may be a valuable marker to predict poor motor recovery in GBS.