Anti-GQ1b antibody syndrome presenting with headache and visual disturbance： a case report and literature review

Objective To analyze and summarize the clinical features of one patient with anti-GQ1b antibody syndrome presenting with rare and atypical manifestations of headache and visual disturbance. Methods Clinical data of a patient with anti-GQ1b antibody syndrome presenting with rare and atypical manifestations of headache and visual impairment were reported. Relevant case reports were retrieved from PubMed, Web of Science, CNKI and Wanfang Data using Chinese search terms of “visual disturbance”“visual impairment”“headache” and “head pain”, and English search terms of “GQ1b”“vision disorders”“visual disorders”“visual disturbance”“headache”“head pain” and “cephalalgia”, etc. Combined with literature review, the pathogenesis, clinical manifestations, laboratory and auxiliary examination and treatment prognosis of patients presenting with this type of manifestations were summarized. Results The 71-year-old male patient had a history of diarrhea at 3 weeks before the onset, manifested with headache and visual disturbance. Cerebrospinal fluid was detected for anti-GQ1b antibody （+） and anti-aquaporin 4 （AQP-4） antibody （-）. He was diagnosed with anti-GQ1b antibody syndrome. Headache symptoms were relieved by steroid treatment, and visual acuity was basically restored after 20 d. According to literature reviews, 9 patients with anti-GQ1b antibody syndrome were manifested with visual impairment and 5 patients presented with headache. All these patients had a history of pre-infection before the onset of disease. Serum or cerebrospinal fluid anti-ganglioside antibody detection contributed to early diagnosis. Prompt use of steroid hormone or immunoglobulin therapy yielded favorable prognosis. Conclusions Patients with anti-GQ1b antibody syndrome can only present with isolated atypical symptoms, such as headache and visual disturbance, if patients have pre-infection histories, early diagnosis and treatment should be performed.