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[Recurrent Miller-Fisher syndrome]
F Battaglia1, F Attane, A Robinson
1Service de Neurologie, Centre Hospitalier A. Gayraud, Carcassonne. fabrice.battaglia@ch-carcassonne.fr
Revue Neurologique
|October 26, 2005
Summary
Recurrent Miller-Fisher syndrome (MFS) is exceptionally rare. This case highlights unusual clinical, biological, and electrophysiological features in a patient with two MFS episodes over 19 years.
Area of Science:
- Neurology
- Autoimmune Disorders
Background:
- Miller-Fisher syndrome (MFS) is a rare autoimmune post-infectious neurological disorder.
- It is characterized by ataxia, ophthalmoplegia, and areflexia, often considered a variant of Guillain-Barré syndrome (GBS).
- MFS is typically associated with anti-GQ1b antibodies and electrophysiological abnormalities.
Observation:
- A 54-year-old woman experienced two episodes of MFS over 19 years.
- The first episode presented as classical MFS, while the second was extensive, involving tetraparesis and respiratory failure.
- This patient had normal CSF protein levels and brain MRI findings.
Findings:
- The patient exhibited strongly positive anti-GQ1b antibodies and slightly positive anti-GM1/anti-GM2 antibodies.
- Electromyography revealed isolated sensory abnormalities in the median nerve territory.
- Campylobacter jejuni serology was negative, ruling out a common trigger.
Implications:
- This case expands the understanding of recurrent MFS, demonstrating unusual clinical presentations.
- It underscores the importance of considering atypical features in recurrent MFS diagnosis.
- The findings contribute to the literature on the variable clinical and biological spectrum of MFS.