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Published Online First: 15 May 2007. doi:10.1136/jnnp.2007.120444
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1276-1277
Copyright © 2007 by the BMJ Publishing Group Ltd.
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SHORT REPORTS
Short report

Chronic ataxic neuropathy mimicking dorsal midbrain syndrome

S D Arbogast, S Khanna, D W Koontz, R L Tomsak, B Katirji, R J Leigh

Department of Neurology, University Hospitals of Cleveland and Daroff-Dell’Osso Laboratory, Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, Ohio, USA

Correspondence to:
Dr R John Leigh, Department of Neurology, 11100 Euclid Avenue, Cleveland Ohio 44106-5040, USA; rjl4{at}case.edu

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.

Abbreviations: CANOMAD, chronic ataxic neuropathy with ophthalmoplegia, IgM paraprotein, cold agglutinins and anti-GD1b disialosyl antibodies; MFS, Miller Fisher syndrome






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