The Miller-Fisher syndrome is caused by antibodies which bind to a specific ganglioside, GQ1b.
Antibody binding blocks the release of acetylcholine at the motor end-plate.
Nerves serving the external ocular muscles are rich in the targeted gangliosides, which may explain the frequency of ophthalmoplegia.
There is a high frequency of Campylobacter infection in the weeks before the onset of the Miller-Fisher syndrome.
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