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Miller-Fisher syndrome mimicking intracranial hypertension following head trauma

S Pulitanò1, L Viola, O Genovese

  • 1Pediatric Intensive Care Unit, Catholic University Medical School-Hospital A. Gemelli, Largo F. Vito, 8, 00168, Rome, Italy. slivia66@yahoo.com

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|April 15, 2005
PubMed
Abstract

Insights

Miller-Fisher syndrome (MFS), a rare neurological disorder, can present atypically with severe symptoms like intracranial hypertension and coma, mimicking head trauma. Early diagnosis and treatment led to a good outcome in a pediatric case.

Area of Science:

  • Neurology
  • Pediatrics
  • Immunology

Background:

  • Miller-Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome.
  • Classic MFS presents with ophthalmoplegia, ataxia, and areflexia.
  • Altered consciousness and intracranial hypertension are exceptionally rare in MFS.

Observation:

  • A 5-year-old girl presented with symptoms mimicking head trauma, including intracranial hypertension, transient coma, and respiratory failure.
  • She also exhibited ataxia, areflexia, ophthalmoplegia, and autonomic disturbances, suggestive of MFS.
  • Initial presentation complicated diagnosis, initially managed as trauma injury.

Findings:

  • Electrophysiologic studies and laboratory tests confirmed an atypical MFS diagnosis.
  • Treatment with immunoglobulins and steroids resulted in progressive clinical improvement.
  • The patient experienced a good final outcome despite the severe initial presentation.

Implications:

  • This case highlights the importance of considering atypical MFS presentations in pediatric patients, even with a history of head injury.
  • It underscores the diagnostic challenge posed by rare neurological disorders mimicking common injuries.
  • Prompt diagnosis and appropriate immunomodulatory therapy are crucial for favorable outcomes in MFS.

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