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Development of facial palsy during immunoadsorption plasmapheresis in Miller Fisher syndrome: a clinical report of two cases
  1. Keiji Chidaa,
  2. Sadao Takasea,
  3. Yasuto Itoyamab
  1. aDepartment of Neurology, Kohnan Hospital, Sendai, Japan, bDepartment of Neurology, Tohoku University School of Medicine, Sendai, Japan
  1. Dr K Chida, Department of Neurology, Kohnan Hospital, 4–20–1 Nagamachi-minami, Taihaku-ku, Sendai 982, Japan.


Immunoadsorption plasmapheresis (IAP) using a tryptophan linked gel column has been shown to effectively remove serum IgG anti-GQ1b antibody which may contribute to the pathogenesis of Miller Fisher syndrome. Two patients are reported on with Miller Fisher syndrome, who developed bilateral facial palsy during IAP using a tryptophan column, while ophthalmoplegia, ataxia, and, areflexia were improving. In these patients, the titre of anti-GQ1b antibodies was reduced. The IAP using a tryptophan column has a beneficial effect on Miller Fisher syndrome but may not inhibit the development of facial palsy. The mechanism of such a dissociated effect of IAP on Miller Fisher syndrome is discussed.

  • Miller Fisher syndrome
  • immunoadsorption
  • plasmapheresis
  • facial palsy
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