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Motor conduction studies in Miller Fisher syndrome with severe tetraparesis
Masahisa Katsuno1, Tetsuo Ando, Shigetaka Hakusui
1Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan. ka2no@med.nagoya-u.ac.jp
Abstract:
Some patients with Miller Fisher syndrome (MFS) have a severe tetraparesis such as that observed in Guillain--Barré syndrome (GBS). To determine whether pathophysiologic differences exist between the tetraparesis in MFS and that in GBS, we compared clinical and motor conduction findings in 4 MFS patients who developed severe tetraparesis with those in 5 MFS patients without tetraparesis, and 14 GBS patients. MFS patients with or without tetraplegia had normal motor conduction velocities, distal motor latencies, compound muscle action potential (CMAP) amplitudes, and F-wave latencies. CMAP amplitude tended to be lower in tetraparetic MFS patients than in MFS patients without tetraparesis, but not significantly. F-wave occurrence was slightly reduced in 1 MFS patient with tetraparesis and 1 MFS patient without tetraparesis. Motor conduction parameters were abnormal in 13 of 14 patients with GBS, and showed demyelinating features in 10. Our results suggest that the pathophysiology of tetraparesis in MFS differs from that in GBS.
Insights
Miller Fisher syndrome (MFS) tetraparesis differs pathophysiologically from Guillain-Barré syndrome (GBS). MFS patients showed normal nerve conduction, unlike GBS patients with demyelinating features.
Area of Science:
- Neurology
- Neurophysiology
Background:
- Miller Fisher syndrome (MFS) can present with severe tetraparesis, mimicking Guillain-Barré syndrome (GBS).
- Understanding the pathophysiologic differences is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate potential pathophysiologic distinctions between tetraparesis in MFS and GBS.
- To compare electrophysiologic findings in MFS patients with and without tetraparesis against GBS patients.
Main Methods:
- Clinical and motor conduction studies were performed.
- Compared 4 MFS patients with tetraparesis, 5 MFS patients without tetraparesis, and 14 GBS patients.
Main Results:
- MFS patients (with or without tetraparesis) exhibited normal motor conduction velocities, distal motor latencies, CMAP amplitudes, and F-wave latencies.
- GBS patients frequently showed abnormal motor conduction parameters, with demyelinating features in most.
- CMAP amplitude was slightly lower in tetraparetic MFS patients, but not significantly.
Conclusions:
- The pathophysiology of tetraparesis in MFS appears distinct from that observed in GBS.
- Electrophysiologic findings suggest MFS tetraparesis is not primarily demyelinating.
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