Three Cases of Acute Ophthalmoplegia without Ataxia / 대한소아신경학회지

ABSTRACT

Acute ophthalmoplegia is caused by various etiologies; cerebrovascular diseases, tumors, infections, diabetes mellitus, multiple sclerosis, and myasthenia gravis. Acute ophthalmoplegia without ataxia(AO), regarded atypical Miller-Fisher syndrome, can be defined as a progressive, relatively symmetric ophthalmoplegia by 4 weeks without ataxia or limb weakness, on circumstance of ruling-out other diseases. The additional features that are strongly supportive of the diagnosis of AO are as follows 1) a history of infectious symptoms within 4 weeks before the onset of neurological symptoms; 2) cerebrospinal fluid albuminocytologic dissociation; and 3) presence of anti-GQ1b IgG antibody. AO has been sporadically reported, but there is still short of information for its clinical and laboratory characteristics in children. We report three children with AO, who were presented with acute ophthalmoplegia without other abnormal neurologic symptoms. All of the patients met the diagnostic criteria of AO, but only one of them had a positive serum anti-GQ1b antibody. So, we need to suspect the diagnosis of AO, even in the cases with negative result of serum anti-GQ1b antibody.