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Recurrent Miller Fisher syndrome.
S Madhavan1, Geetha, P V Bhargavan
1Department of Medicine, Medical College, Calicut.
The Journal of the Association of Physicians of India
|January 14, 2005
Summary
Recurrent Miller Fisher syndrome (MFS), a Guillain-Barré variant, is exceptionally rare. This case report details two MFS episodes in one patient over two years, highlighting atypical recurrence for this neurological disorder.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Miller Fisher syndrome (MFS) is a rare autoimmune disorder and a variant of Guillain-Barré syndrome.
- MFS is typically characterized by ophthalmoplegia, ataxia, and areflexia, with recurrences being exceedingly uncommon.
Observation:
- This report presents a unique case of a patient experiencing two distinct episodes of MFS within a two-year timeframe.
- The initial presentation involved partial ophthalmoplegia and ataxia, while the second episode manifested as a full triad of ataxia, areflexia, and ophthalmoplegia.
Findings:
- Cerebrospinal fluid (CSF) analysis remained consistent with MFS during both episodes.
- Nerve conduction velocity studies and brain MRI were within normal limits, underscoring the clinical diagnosis.
- The patient initially received symptomatic treatment, followed by steroid therapy during the second MFS episode, with positive response.
Implications:
- This case underscores the possibility of recurrent MFS, challenging the notion of its exceptional rarity.
- It highlights the importance of considering recurrent MFS in patients presenting with similar neurological symptoms, even after a prior MFS diagnosis.
- The varied response to treatment suggests further research into optimal therapeutic strategies for recurrent MFS is warranted.