Neurological Sciences

, Volume 40, Issue 4, pp 891–893 | Cite as

A case report of Fisher syndrome with the detection of anti-GM3 and anti-GD1b IgG antibodies

  • Kosuke MatsuzonoEmail author
  • Tadashi Ozawa
  • Keisuke Yoshikawa
  • Susumu Kusunoki
  • Shigeru Fujimoto
Letter to the Editor


Antiganglioside antibodies play an important role in the pathogenesis of Guillain–Barré syndrome (GBS) and Fisher syndrome (FS) [1]. FS is a variant form of GBS and is characterized by the triad symptoms of opthalmoplegia, ataxia, and areflexia. While serum anti-GQ1b IgG antibody is positive in almost 90% of cases of FS, associations with the other antiganglioside antibodies are rare [2]. The anti-GD1b IgG antibody is reported to be associated with ataxia in a few GBS cases [3]. The pathogenesis associated with anti-GM3 IgG antibody in GBS or FS remains unknown, but is reported to be associated with narcolepsy-cataplexy [4]. However, there has been no report of typical FS associated with anti-GD1b and anti-GM3 IgG antibodies. Here, we report for the first time a FS case that developed the triad symptoms and was anti-GQ1b IgG antibody negative but anti-GD1b and anti-GM3 IgG antibody positive.

Case presentation

A 48-year-old healthy man suddenly developed ophthalmoplegia,...



We appreciate the cooperation of the patient. We also thank Kate Fox, DPhil, from Edanz Group ( for editing a draft of this manuscript.

Authors’ contributions

K.M. and T.O. were the attending doctors for the present case. K.Y. and S.K. investigated for antiganglioside antibodies. K.M. and K.Y. drafted the manuscript. S.K. and S.F. conceived the study, participated in its coordination, and helped to draft the manuscript. All authors read and approved the final manuscript.


This work was supported in part by the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grants-in-Aid for Scientific Research, 15H04845 and 18H02745), and the Ministry of Health, Labour and Welfare of Japan [Health and Labour Sciences Research Grant on Rare and Intractable Diseases (Validation of Evidence-based Diagnosis and Guidelines, and Impact on QOL in Patients with Neuroimmunological Diseases)].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical standards

Informed consent was obtained from the patient described in this article.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Neurology, Department of Internal MedicineJichi Medical University School of MedicineShimotsukeJapan
  2. 2.Department of Neurology, Faculty of MedicineKindai UniversityOsaka-SayamaJapan

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