Alternating XXXX associated with asialo-GM1 and GD1b antibodies.

@entity1 @entity4894 @entity8954 @entity809 @entity4836 @entity1736 @entity1729 @entity8108 @entity4163 @entity427 @entity2055 @entity934
@entity4894 ( @entity4894 ), variant of acute inflammatory demyelinating @entity8954 , is recognized as clinical triad ( @entity4894 ). @entity4163 antibodies play an important role in the pathogenesis of acute @entity8954 including @entity4894 . To our knowledge, there has been no report of @entity4894 presenting with atypical alternating @entity1736 or with concurrent elevation of serum GD1 and asialo-GM1 antibody titers, and negative titers of GQ1b antibody such as our @entity1 . Our objective is to report @entity4894 with unusual symptoms and to share our diagnostic approach. We report a rare case of @entity4894 presenting with alternating @entity1736 , @entity809 , and @entity2055 after a @entity1729 . Initial neurological examination revealed @entity1736 , @entity427 , positive Romberg sign, and @entity2055 . The ice pack test was negative. Three days later, contralateral @entity1736 was observed, associated with @entity4894 and @entity2055 . However, there was significant improvement of the previous @entity1736 . Serology revealed elevated asialo-GM1 and GD1b antibodies. @entity934 receptor antibodies were negative. Cerebral spinal fluid revealed elevated IgG index. Nerve conduction studies (NCS) performed four days after the onset of symptoms showed normal nerve conduction velocities and F-waves, and absent bilateral @entity8108 -reflexes. Repetitive nerve stimulation (3 Hz) showed no decrement of compound muscle action potentials. Trial with a single dose of @entity4836 showed no clinical improvement. The symptoms resolved without intervention. NCS 18 days after onset of symptoms showed mildly prolonged F-waves and absent H-reflexes. This case highlights an atypical presentation of @entity4894 and raises the awareness of a rare autoantibody associated with it.
