Chronic ataxic neuropathy mimicking dorsal midbrain syndrome

J Neurol Neurosurg Psychiatry. 2007 Nov;78(11):1276-7. doi: 10.1136/jnnp.2007.120444. Epub 2007 May 15.

Abstract

We describe the clinical course, with special attention to the disturbance of eye movements, of a 29-year-old man with chronic ataxic neuropathy with ophthalmoplegia, IgM paraprotein, cold agglutinins and anti-GD1b disialosyl antibodies (CANOMAD). Using the magnetic search coil technique, we documented convergence during upward saccades and other features suggestive of dorsal midbrain syndrome. Thus, in common with Miller Fisher syndrome, CANOMAD may present with clinical findings implicating involvement of the central nervous system, which contains ganglioside antigens to anti-GD1b antibodies.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Anemia, Hemolytic, Autoimmune / diagnosis*
  • Anemia, Hemolytic, Autoimmune / immunology
  • Anemia, Hemolytic, Autoimmune / therapy
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Autoantibodies / blood*
  • Diagnosis, Differential
  • Gait Ataxia / diagnosis*
  • Gait Ataxia / immunology
  • Gait Ataxia / therapy
  • Gangliosides / immunology*
  • Humans
  • Immunoglobulin M / blood*
  • Male
  • Mesencephalon*
  • Neurologic Examination
  • Ophthalmoplegia / diagnosis*
  • Ophthalmoplegia / immunology
  • Ophthalmoplegia / therapy
  • Paraproteinemias / diagnosis*
  • Paraproteinemias / immunology
  • Paraproteinemias / therapy
  • Plasma Exchange
  • Rituximab
  • Syndrome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Autoantibodies
  • Gangliosides
  • Immunoglobulin M
  • ganglioside, GD1b
  • Rituximab