{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T21:19:11Z","timestamp":1784063951645,"version":"3.55.0"},"reference-count":5,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,19]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>A young woman presented to neurology with a 1 month history of progressive diplopia on lateral gaze and a 1 week history of headaches. On examination she was found to have complex ophthalmoparesis with binocular horizontal diplopia, failure of abduction bilaterally and limited upgaze with convergence-retraction nystagmus. The rest of the neurological examination was normal. She was admitted for investigations: blood, CT brain, MR brain and lumbar puncture results were normal. Anti-GD1a antibodies were strongly positive; anti-GM1, anti-GM2 and anti-GD1b were also positive. On follow-up 3 weeks later, the complex ophthalmoplegia persisted. It was decided to treat with intravenous immunoglobulins (IVIgs) with good response but recurrence at 2 weeks post infusion. She was treated with 4 weekly IVIg courses and remains responsive and controlled over 1 year since presentation but becomes symptomatic in the week running up to each dose; thus, disease modifying treatment is currently being considered.<\/jats:p>","DOI":"10.1136\/bcr-2021-244273","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T11:42:22Z","timestamp":1637235742000},"page":"e244273","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Immune-mediated ophthalmoparesis with anti-GD1a antibodies"],"prefix":"10.1136","volume":"14","author":[{"given":"Norma","family":"McKean","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Mater Dei Hospital, Msida, Malta"},{"name":"Department of Medicine, University of Malta, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charmaine","family":"Chircop","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Mater Dei Hospital, Msida, Malta"},{"name":"Department of Medicine, University of Malta, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"2025082804370476000_14.11.e244273.1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awf272"},{"key":"2025082804370476000_14.11.e244273.2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073807301921"},{"key":"2025082804370476000_14.11.e244273.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2006.04.005"},{"key":"2025082804370476000_14.11.e244273.4","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/WNO.0000000000000156","article-title":"Anti-asialo-GM1 and GD1a variant of miller fisher variant of guillain-barr\u00e9 syndrome","volume":"34","author":"Morgan","year":"2014","journal-title":"J Neuroophthalmol"},{"key":"2025082804370476000_14.11.e244273.5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2001.00271.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:37:13Z","timestamp":1756381033000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":5,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,18]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bcr-2021-244273"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244273","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}