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J Neurol Neurosurg Psychiatry 72:680 doi:10.1136/jnnp.72.5.680
  • Letter

Plasmapheresis and Miller Fisher syndrome: analysis of 50 consecutive cases

  1. M Mori,
  2. S Kuwabara,
  3. T Fukutake,
  4. T Hattori
  1. Department of Neurology, Chiba University School of Medicine 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670 Japan;
  1. Correspondence to:
 Dr Mori, 
 morim{at}olive.ocn.ne.jp

    Miller Fisher syndrome (MFS), characterised by the clinical triad of ataxia, ophthalmoplegia, and areflexia, is considered to be a variant form of Guillain-Barré syndrome (GBS). Large studies have shown that plasmapheresis1 and immunoglobulin treatment2 are beneficial for treating GBS. Because of the close relation between GBS and MFS, plasmapheresis may prove efficacious for treating MFS and has actually been tried in some cases. Moreover, because antibody to GQ1b is often present in serum from patients with MFS and is suggested to have a role in the pathophysiology of MFS, removing this antibody through plasmapheresis should have beneficial effects on patients with this syndrome. Although several reports have described possible plasmapheresis benefits in treating MFS,3,4 none has compared its clinical effects in patients treated and not treated with plasmapheresis. We conducted a retrospective analysis of 50 consecutive patients with MFS to clarify whether plasmapheresis enhanced the speed of recovery.

    Medical records of 53 patients with MFS, seen at Chiba University Hospital or its affiliated hospitals between 1979 and 1999, were reviewed. These patients were described in our previous investigation of the natural course of MFS.5 Criteria for inclusion in the study …