Miller-Fisher Syndrome.

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Suntaree Thitiwichienlert
Wimolwan Tangpagasit

Abstract

Background: The Guillain-Barré syndrome (GBS) is an acute idiopathic polyneuritis, it has several variants. Miller-Fisher syndrome (MFS) is an uncommon variant of GBS and is characterized by a triad of acute ophthalmoplegia, ataxia, and areflexia. The difference between common variants of GBS and MFS is that GBS exhibits limb weakness, whereas in MFS the limb weakness is absent.


Case Report: We present a 60-year-old male complaining of bilateral progressive ptosis and gait ataxia. Eye examinations revealed bilateral ptosis and complete total ophthalmoplegia. Neurological examinations revealed normal deep tendon reflexes and no motor or sensory deficits. MRI brain and orbit demonstrated normal cavernous sinuses and brainstem. Lumbar puncture revealed albuminocytological dissociation. The diagnosis was confirmed by a serum test showing anti-GQ1b antibody seropositivity.


Conclusion: MFS is uncommon and may be frequently misdiagnosed as brainstem stroke or myasthenia gravis. Neurological examinations are of clinical importance. MFS must be considered in the differential diagnosis in patients presenting with bilateral total ophthalmoplegia and ataxia or areflexia.


Conflict of interest: none.

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References

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