Anti-GQ1b-Negative Miller Fisher Syndrome with Acute Areflexic Mydriasis and Cholinergic Supersensitivity

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Yildiz Ö. , BALABAN H. , ÖZDEMİR S. , BOLAYIR E. , Topaktas S.

NEURO-OPHTHALMOLOGY, vol.35, no.1, pp.40-42, 2011 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 1
  • Publication Date: 2011
  • Doi Number: 10.3109/01658107.2010.539761
  • Title of Journal : NEURO-OPHTHALMOLOGY
  • Page Numbers: pp.40-42


Miller Fisher syndrome is a rare variant of Guillain-Barre syndrome and it is characterised by ophthalmoplegia, ataxia, and areflexia. Pupillomotor involvement occurs in approximately half of the patients with the disorder. The authors report a patient with acute areflexic mydriasis, external ophthalmoplegia, areflexia, and ataxia. Although the pupils were unreactive to light and near stimuli, administration of 0.1% pilocarpine resulted in marked miosis, suggesting cholinergic supersensitivity. Antibodies against GM1, GD1b, and GQ1b were negative. This is the first report of acute areflexic mydriasis with cholinergic supersensitivity in anti-GQ1b-negative Miller Fisher syndrome.