PT - JOURNAL ARTICLE AU - Fanny Huynh Du AU - Alexan Yerevanian AU - Matthew Shtrahman TI - Acute ophthalmoplegia in a patient with anti-GQ1b antibody and chronic facial diplegia AID - 10.1136/bcr-2020-234319 DP - 2020 Jul 01 TA - BMJ Case Reports PG - e234319 VI - 13 IP - 7 4099 - http://casereports.bmj.com/content/13/7/e234319.short 4100 - http://casereports.bmj.com/content/13/7/e234319.full SO - BMJ Case Reports2020 Jul 01; 13 AB - A 56-year-old man with a remote history of bilateral recurrent facial palsies presented with a week of ophthalmoplegia with intact deep tendon reflexes and lack of ataxia, cerebrospinal fluid with albuminocytologic dissociation and elevated serum anti-ganglioside Q1b (GQ1b) IgG antibody. We diagnosed the patient with acute ophthalmoplegia without ataxia, a condition under the spectrum of anti-GQ1b antibody syndromes which also includes Miller Fisher syndrome. Given the rarity of recurrent facial palsies and anti-GQ1b antibody syndromes as well as reports associating facial palsies and this syndrome, we suggest that our case may be an unusual presentation of an anti-GQ1b antibody syndrome beginning with recurrent facial palsies several years prior to ophthalmoplegia. Prior studies of human nerves provide insight into the pathophysiology, including ganglioside distribution and cross-reactivities underlying the heterogeneity of anti-GQ1b antibody syndromes. This report may expand the differential diagnosis in patients with recurrent facial palsies and broaden the phenotype of anti-GQ1b syndromes.