Clinical significance of the anti-GQ1b-antibodies in patients with Miller-Fisher-syndrome

Antibodies against gangliosides are often positive in the Guillain-Barre and Miller Fisher syndromes. Antibodies against ganglioside GQ(1b) are highly associated with Miller Fisher syndrome. We report on 7 patients with the typical triad for Miller Fisher syndrome ataxia, areflexia and ophthalmoplegia. Anamnestic data revealed a precedent respiratory or gastrointestinal infection in 5 patients. Sera were analysed by ELISA for anti-GQ(1b). Positive titres were found in all 7 patients. Repeated measurements showed a slow decrease of antibody titre. No correlation between anti-GQ(1b) antibodies and clinical severity or increased protein levels of cerebral spinal fluid could be found. The slow decrease of the anti-GQ(1b) antibodies and the mainly IgG isotope of the antibodies suggest a T-cell mediated immune response. The pathological relevance and the role of the anti-GQ(1b) antibodies in the course of the disease remain to be investigated.