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An unusual presentation of Guillain–Barré syndrome associated with monospecific anti-GD1b antibodies
  1. Maarten Dewil1,
  2. Wim Robberecht1,2,
  3. Philip Van Damme1,2
  1. 1Department of Neurology, University Hospital Leuven, Leuven, Belgium
  2. 2Laboratory of Neurobiology, University of Leuven, and Vesalius Research Center, VIB, Leuven, Belgium
  1. Correspondence to Dr Philip Van Damme, Department of Neurology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; philip.vandamme{at}uz.kuleuven.be

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Introduction

Antibodies monospecific to one ganglioside are helpful in delineating the antibody–phenotype correlation in Guillain–Barré syndrome (GBS). GD1b antibodies have mainly been associated with a sensory ataxic variant of GBS.

We describe a patient with GBS after CMV infection with antibodies monospecific to ganglioside GD1b. The clinical presentation of this patient extends the spectrum of GD1b-associated phenotypes with asymmetrical weakness in the limbs, unilateral facial palsy, unilateral abducens palsy and respiratory impairment.

Case report

A 58-year-old man was referred because of progressive difficulties with walking 3 weeks after a respiratory-tract infection. The neurological deficit progressed over a few days with muscle weakness mainly on the right side of his body, asymmetrical paraesthesias, double vision and a facial palsy. On neurological examination he had a left abducens, a right facial palsy and profound muscle weakness, especially on the right side, with only minor sensory abnormalities. At the peak of symptoms there was weakness (MRC grade 4) of the neck muscles. In the limbs, there was weakness most pronounced on the right side (MRC …

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