THEME: ANTIBODIES BEHAVING BADLY - WHAT LIES BENEATH APPEARING
AND DISAPPEARING NEUROLOGICAL SYNDROMES
It is well recognised that diseases of the peripheral nervous system can be caused by
autoantibodies and respond well to immunotherapies, associated with a fall in antibody
levels. The best examples are, of course, myasthenia gravis and Lambert-Eaton myasthenic
syndrome, with antibodies to the acetylcholine receptor and voltage-gated calcium channels,
respectively. Guillain-Barre syndrome and Miller-Fisher syndrome are associated with
antibodies to gangliosides such as GM1 and GQ1b, although these conditions are not
necessarily, exclusively, antibody- mediated. VGKC antibodies are seen in compulsive and
psychotic disorders and on brain FDG-PET basal ganglia hypometabolism has been
documented. They too respond to immunosuppressive treatment.
In India, probably 10 patients per million per year could be diagnosed with diseases caused
by antibodies.