Acute ophthalmoparesis associated with anti-GM1, anti-GD1a, and anti-GD1b antibodies after enterovirus infection in a 6-year-old girl.

ABSTRACT

This article presents a 6-year-old girl who developed acute unilateral third cranial nerve palsy in the absence of any other sign of central nervous system involvement. Raised titers of immunoglobulin M antibodies against GM1, GD1a, and GD1b ganglioside components were demonstrated. Ten days earlier, the girl had experienced acute gastroenteritis with positive specific immunoglobulin M antibodies against enterovirus. The results of all other laboratory tests usually performed for infectious diseases were negative, and neuroradiologic findings were also normal. Oral prednisone was administered for a few days, and the ophthalmoparesis fully resolved within 1 month. Two months later, a second episode of isolated ophthalmoparesis occurred, again associated with a positive immunoglobulin M reaction against GM1, GD1a, and GD1b antigens. This report discusses the relationship between acute isolated ophthalmoparesis and antiganglioside antibodies.