Syndrome de Miller-Fischer, anticorps anti-GQ 1b et Campylobacter jejuni: à l'occasion d'une observation

A case of Miller-Fischer syndrome is reported with serum antibody to ganglioside GQ 1b. Though no abdominal signs or diarrhoea have been elicited, elevated antibody titles to Campylobacter jejuni were found. Rapid improvement is obtained with intraveinous immunoglobulins. Previous publications report elevated titles of IgG antibody to ganglioside GQ 1b in patients with the Miller-Fischer syndrome whereas they are not found in other neurologic conditions and normal controls. This high specificity might he helpful in atypical cases. Prominent distribution of GQ 1b in oculomotor nodes and cerebellum could account for ataxia and ophtalmoplegia, main features of the Miller-Fischer syndrome. Moreover, anti-GQ 1b antibody recognize surface epitopes on C. jejuni, suggesting molecular mimicry. Thus, initiation of immunologic disorder might follow Campylobacter infection. However, other factors were found to explain onset of the disease whatever their correlation with host or bacteria.