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Miller Fisher syndrome presenting as palate paralysis
Mohammad Hassan A Noureldine1, Ahmad Sweid2, Rechdi Ahdab3
1Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Abstract:
We report a 63-year old patient who presented to our care initially with a hypernasal voice followed by ataxia, ptosis, dysphonia, and paresthesias. The patient's history, physical examination, and additional tests led to a Miller Fisher syndrome (MFS) diagnosis. Palatal paralysis as an inaugurating manifestation of MFS is quite rare and requires special attention from neurologists and otolaryngologists. Although it may present as benign as an acute change in voice, early diagnosis and prompt management may prevent further complications.
Insights
Miller Fisher syndrome (MFS) can rarely begin with palatal paralysis, causing a hypernasal voice. Early diagnosis and treatment are crucial for managing this rare neurological condition and preventing complications.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Miller Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome.
- It is characterized by ophthalmoplegia, ataxia, and areflexia.
Observation:
- A 63-year-old patient presented with a hypernasal voice, progressing to ataxia, ptosis, dysphonia, and paresthesias.
- The initial symptom of palatal paralysis leading to voice change was a rare presenting feature.
Findings:
- Diagnostic workup confirmed Miller Fisher syndrome (MFS).
- Palatal paralysis as the inaugurating manifestation of MFS is uncommon.
Implications:
- This case highlights the importance of recognizing rare MFS presentations.
- Prompt diagnosis and management by neurologists and otolaryngologists are essential to prevent severe complications.
