Recurrent Miller Fisher syndrome

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.