Three weeks after a febrile diarrhoeal illness, a 31-year-old man develops diplopia, gait unsteadiness, and areflexia. He can write and speak normally, power is full, and brain MRI is normal. Serum antibodies are most likely directed against:

• A GQ1b ganglioside ✓
• B GM1 ganglioside
• C Presynaptic voltage-gated calcium channel
• D Acetylcholine receptor

Explanation

Miller Fisher syndrome, the ophthalmoplegia, ataxia and areflexia variant of Guillain-Barre syndrome, is strongly linked to IgG antibodies against the GQ1b ganglioside, present in over 90 percent of cases, often after Campylobacter jejuni infection. Anti-GM1 relates to acute motor axonal neuropathy with weakness, while VGCC and AChR antibodies define LEMS and myasthenia gravis respectively.

Reference: Adams and Victor's Principles of Neurology, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.