Case reportRecurrent Miller–Fisher syndrome
Introduction
Miller–Fisher syndrome (MFS) is an uncommon variant of Guillain–Barre syndrome (GBS). Recurrences of GBS are well documented but repeated episodes of MFS are very rarely seen in clinical practice.1 We describe a case of recurrent Miller–Fisher Syndrome where three similar episodes occurred with complete recovery between each over a twelve-year period.
Section snippets
Case history
In June 1989 a previously well 57-year-old male developed subacute onset of acral paraesthesia and numbness, associated with lethargy and headache three days after an upper respiratory tract infection (URTI). The symptoms progressed over the next four days and the patient presented to emergency with a drooping left eyelid, double vision, and difficulty in walking. Examination demonstrated a left ptosis, loss of horizontal gaze and sparing of vertical gaze. Pupillary responses were normal and
Discussion
Miller–Fisher syndrome is a clinical variant of Guillain–Barre Syndrome. The classical triad of symptoms consists of ataxia, areflexia and ophthalmoplegia, although other cranial nerves can be involved and there is frequently a degree of peripheral sensory and motor disturbance.3 Both GBS and MFS share a number of features: increased cerebrospinal fluid protein with mild or absent pleocytosis, responsiveness to immune modulatory therapies, and association with various antecedent infections
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Recurrent Guillain-Barré syndrome, Miller Fisher syndrome and Bickerstaff brainstem encephalitis
2016, Journal of the Neurological SciencesCitation Excerpt :To determine whether patients at other institutions displayed a similar pattern, we conducted a PubMed search that identified studies including a total of 32 (30 adults and 2 children) patients with recurrent MFS. Details of clinical courses were described for 14 patients [15,17–19,22,31–37]. There were 18 recurrent episodes in these 14 patients.
Recurrent Miller-Fisher syndrome
2005, Revue NeurologiqueClinical and antibodies analysis of anti-GQ1b antibody syndrome: a case series of 15 patients
2023, Acta Neurologica BelgicaAn Overview of Autoimmune and Paraneoplastic Encephalitides
2018, Seminars in NeurologyMiller Fisher Syndrome and Bickerstaff's Encephalitis: 2 Sides of the Same Coin
2016, Aktuelle Neurologie