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Ataxia, ophthalmoplegia, and areflexia: what would you think?

N Karsan1, P Fletcher, I Bodi

  • 1Neurology Department, St Georges Healthcare NHS Trust, London SW17 0QT, UK.

Case Reports in Neurological Medicine
|August 31, 2012
PubMed

Insights

This study details a rare case of carcinomatous meningitis mimicking Miller Fisher syndrome (MFS). Further research is needed to explore potential paraneoplastic mechanisms linking cancer with MFS.

Area of Science:

  • Neurology
  • Oncology
  • Immunology

Background:

  • Carcinomatous meningitis is a rare complication of cancer.
  • Miller Fisher syndrome (MFS) is a variant of Guillain-Barré syndrome.
  • The association between cancer and MFS is not well-established.

Purpose of the Study:

  • To present a case of carcinomatous meningitis with MFS phenotype.
  • To review existing literature on cancer and MFS.
  • To investigate potential paraneoplastic mechanisms.

Main Methods:

  • Case report.
  • Literature review.
  • Cerebrospinal fluid (CSF) analysis.
  • Histopathological examination.
  • Antiganglioside antibody testing.

Main Results:

  • A case of carcinomatous meningitis presenting as MFS was identified.
  • Four cases with central nervous system (CNS) tumor invasion and MFS phenotype were found.
  • Five cases showed an association between cancer and MFS phenotype, with some having antiganglioside antibodies.

Conclusions:

  • Carcinomatous meningitis can present as MFS.
  • A paraneoplastic etiology for MFS associated with cancer is plausible.
  • Further investigation including histological examination and antibody testing is warranted in similar cases.

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