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Recurrent Miller Fisher syndrome: clinical and laboratory features
1Department of Neurology, Klinikum Landshut, Robert-Koch-Strasse 1, Landshut, Germany. josef.heckmann@klinikum-landshut.de
European Journal of Neurology
|November 29, 2011
Summary
Recurrence of Miller Fisher syndrome (MFS) is rare but documented, with a mean interval of 9.45 years between episodes. Most patients experience a favorable outcome after immunotherapy, even with multiple recurrences.
Area of Science:
- Neurology
- Immunology
Background:
- Miller Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome.
- Recurrent MFS is exceptionally uncommon, with limited literature available.
Observation:
- Two patients presented with MFS recurrence after 35 and 44 years.
- A literature review identified 28 patients with 70 MFS episodes, including single and multiple recurrences.
- The mean interval between MFS attacks was 9.45 years, with preceding infections common.
Findings:
- Recurrent MFS typically presents with ophthalmoplegia, ataxia, and areflexia, often accompanied by facial/bulbar symptoms and autonomic dysfunction.
- Anti-GQ1b antibodies were positive in all tested episodes.
- Cerebrospinal fluid and electrodiagnostic findings were generally non-specific.
Implications:
- Recurrence of MFS, though rare, is a recognized phenomenon.
- The condition generally has a favorable prognosis, with immunotherapy showing positive outcomes in about half of the patients.
- Understanding recurrent MFS patterns aids in diagnosis and management of this rare neurological disorder.
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