Isolated ptosis as acute ophthalmoplegia without ataxia, positive for anti-GQ1b immunoglobulin G

Pediatr Neurol. 2009 Dec;41(6):451-2. doi: 10.1016/j.pediatrneurol.2009.07.008.


Anti-GQ1b IgG antibody syndrome comprises a wide range of diseases presenting with ophthalmoplegia and ataxia. Anti-GQ1b antibodies have been strongly associated in the literature with Miller Fisher Syndrome, with acute ophthalmoplegia associated with Guillain-Barré syndrome, and with isolated ophthalmoplegia. Acute ophthalmoplegia presents as various combinations of external and internal ophthalmoplegia. Reported here is a novel case of isolated ptosis as a manifestation of ophthalmoplegia. The present finding of bilateral ptosis and areflexia with anti-GQ1b IgG antibody positivity helps confirm the existence of the syndrome. Further research is needed on diagnosis and treatment.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Ataxia / diagnosis
  • Autoantibodies / blood*
  • Autoimmune Diseases of the Nervous System / diagnosis*
  • Autoimmune Diseases of the Nervous System / immunology
  • Autoimmune Diseases of the Nervous System / therapy
  • Blepharoptosis / diagnosis*
  • Blepharoptosis / immunology*
  • Blepharoptosis / therapy
  • Child, Preschool
  • Gangliosides / immunology*
  • Humans
  • Immunoglobulin G / blood*
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Male
  • Ophthalmoplegia / diagnosis*
  • Ophthalmoplegia / immunology
  • Ophthalmoplegia / therapy
  • Reflex
  • Syndrome
  • Treatment Outcome


  • Autoantibodies
  • Gangliosides
  • Immunoglobulin G
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • GQ1b ganglioside