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Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents
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[Alert patients with mydriasis and fixed pupils]
Vera E W H Meys1, Peter J Koehler
1Atrium Medisch Centrum, afd. Neurologie, Heerlen.
Nederlands Tijdschrift Voor Geneeskunde
|April 3, 2014
Summary
Miller Fisher syndrome, a rare cause of mydriasis, involves ophthalmoplegia, ataxia, and areflexia. It can be triggered by infections or vaccinations, with most patients recovering spontaneously.
Area of Science:
- Neurology
- Immunology
Background:
- Mydriasis (dilated pupil) in non-comatose patients is uncommon, often linked to toxins or oculomotor nerve issues.
- Miller Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome, characterized by ophthalmoplegia, ataxia, and areflexia.
Observation:
- Two patients presented with mydriasis following influenza vaccination and doxycycline use, respectively.
- Both patients exhibited ophthalmoplegia, ptosis, and ataxia, with the first experiencing transient ataxia and the second reporting headache.
Findings:
- GQ1b-antibodies were detected in both patients, confirming a diagnosis of Miller Fisher syndrome.
- One patient recovered spontaneously, while the other received immunoglobulin treatment.
Implications:
- This case series highlights MFS as a potential cause of mydriasis in specific clinical contexts.
- The findings underscore the autoimmune basis of MFS, often triggered by infections or vaccinations, and suggest a generally favorable prognosis with potential for immunotherapy.
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