J Neurol Neurosurg Psychiatry 77:1043-1046 doi:10.1136/jnnp.2006.087940
  • Paper

Anti-ganglioside complex antibodies in Miller Fisher syndrome

  1. K Kaida1,
  2. M Kanzaki1,
  3. D Morita2,
  4. K Kamakura1,
  5. K Motoyoshi1,
  6. M Hirakawa2,
  7. S Kusunoki2
  1. 1Third Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama-Ken, Japan
  2. 2Department of Neurology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan
  1. Correspondence to:
 Dr Susumu Kusunoki
 Department of Neurology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan; kusunoki-tky{at}
  • Received 13 January 2006
  • Accepted 24 March 2006
  • Revised 10 March 2006
  • Published Online First 13 April 2006


Background: Some ganglioside complexes (GSCs) are target antigens for serum antibodies in patients with Guillain–Barré syndrome (GBS). Anti-GSC antibodies may be associated with particular clinical features of GBS.

Objective: To investigate antibodies to GSCs in the sera of patients with Miller Fisher syndrome (MFS) characterised by elevation of the IgG anti-GQ1b antibody.

Results: In all, 7 of 12 (58%) consecutive patients with MFS were found to have IgG antibodies to GSCs containing GQ1b, of whom 5 had IgG antibodies to GQ1b-GM1 complex (GQ1b/GM1) and 2 had antibodies to GQ1b/GD1a; 4 of 5 patients without sensory symptoms had anti-GQ1b/GM1 antibodies.

Conclusions: At least three different specificities in MFS-associated antibodies, GQ1b-specific, anti-GQ1b/GM1-positive and anti-GQ1b/GD1a-positive, were observed. In patients with MFS not only GQ1b itself but also clustered epitopes of GSCs, including GQ1b, may be considered to be prime target antigens for serum antibodies. A tendency to escape sensory disturbances is shown by anti-GQ1b/GM1-positive MFS.


  • Published Online First 13 April 2006

  • Competing interests: None.

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