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Published on: August 30, 2019
Recurrent Miller Fisher syndrome with vestibular involvement.
G Vermeersch1, A Boschi, N Deggouj
1Service de Neurologie et Laboratoire de Neurochimie, Université Catholique de Louvain, Brussels, Belgium.
European Neurology
|September 22, 2011
Summary
This case study details a patient with recurrent Miller Fisher syndrome over 20 years. High anti-GQ1b IgG antibodies persisted despite recovery, suggesting complex immune responses in this rare neurological disorder.
Area of Science:
- Neurology
- Immunology
- Ophthalmology
Background:
- Miller Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome.
- It is characterized by the triad of ophthalmoplegia, ataxia, and areflexia.
Observation:
- A patient experienced four relapses of MFS over two decades.
- The third relapse lacked ataxia, and the fourth showed central oculomotor signs and subclinical visual-evoked potential slowing.
- Brain imaging remained normal throughout the relapses.
Findings:
- High levels of anti-GQ1b IgG antibodies were detected during the second relapse.
- These antibodies persisted after the fourth relapse, even with complete clinical recovery.
- The findings suggest a complex, potentially atypical, immune-mediated process in recurrent MFS.
Implications:
- Recurrent MFS can present with atypical symptoms, including central nervous system involvement.
- Persistent anti-GQ1b IgG antibodies may indicate ongoing immune activity despite clinical remission.
- This case highlights the importance of monitoring antibody levels in relapsing cases of MFS.
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