This Is A Novel Case A Variant Of Miller-Fisher Syndrome With A Positve Anti-GQ1b Antibody Presenting As Parinaud’s Syndrome. (P5.038)
Bibliographic record
Abstract
OBJECTIVE: Here we present a 29 year old male with Parinaud’s Syndrome who is positive for Anti-GQ1b antibody which is highly specific for Miller Fisher Syndrome(MFS) BACKGROUND: Parinaud's Syndrome, also known as dorsal midbrain syndrome is a group of abnormalities of eye movement and pupil dysfunction. It is caused by lesions of the upper brain stem. It is a cluster of abnormalities of eye movement and pupil dysfunction, characterized by: Paralysis of upgaze, Pseudo-Argyll Robertson pupils, Convergence-Retraction nystagmus, and Eyelid retraction (Collier's sign). Miller Fisher syndrome (MFS) is characterized by the acute onset of external ophthalmoplegia, ataxia of a cerebellar type, and the loss of tendon reflexes. Acute onset of external ophthalmoplegia is a cardinal feature. Anti-GQ1b antibodies are prominent in MFS, and have a relatively high specificity and sensitivity for the disease. It is considered a variant of Guillain-Barré syndrome (GBS), because some patients who present with MFS progress to GBS. RESULTS: This is a case report of a 29 year old male who presented with a sudden change in vision. Examination revealed Parinaud’s Syndrome. Given his preceding history of diarrhea along with new onset opthalmoplegia, ataxia, and areflexia, anti-GQ1b antibodies were requested. The resulting titre was positive confirming the suspected diagnosis of Miller Fisher syndrome. Brain imaging showed no lesion or hydrocephalus as cause for patients symptoms. He responded to intravenous immunoglobulins with full resolution of his symptoms and signs. CONCLUSIONS: We present a 29 year old male with sudden onset Parinaud’s Syndrome in the context of ataxia and areflexia. Anti-GQ1b antibody titres were positive which is highly specific for Miller Fisher Syndrome. This is a novel case of Parinaud's syndrome being the presenting symptom for Miller Fisher syndrome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".