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Forme fruste anti-GQ1b-negative Miller Fischer syndrome masquerading as posterior circulation stroke
Benjamin Ng Han Sim1, Joyce Pauline Joseph2
1Neurology Department, Hospital Kuala Lumpur, 23, Jalan Pahang, 50586 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia, drben84@gmail.com.
Abstract:
Miller Fischer syndrome (MFS) is a variant of Guillain-Barré syndrome first described in 1956 and is characterised by the clinical triad of ophthalmoplegia, ataxia and areflexia. However, since its discovery, forme fruste and overlapping syndrome have been described. A forme fruste of MFS implies an attenuated form where not all of the clinical triad are present. In this report, a case of MFS is highlighted that was mistakenly treated as posterior circulation stroke, as well as the challenges faced in reaching the correct diagnosis and hence the appropriate treatment.
Insights
Miller Fisher syndrome (MFS), a Guillain-Barré syndrome variant, presents with ophthalmoplegia, ataxia, and areflexia. This case highlights diagnostic challenges, including misdiagnosis as stroke, emphasizing the need for accurate MFS identification.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Miller Fisher syndrome (MFS) is a rare neurological disorder and a variant of Guillain-Barré syndrome.
- It is classically defined by ophthalmoplegia, ataxia, and areflexia.
Observation:
- This report details a case of MFS initially misdiagnosed and treated as posterior circulation stroke.
- The patient's presentation illustrated challenges in diagnosing MFS, particularly forme fruste variants.
Findings:
- The case underscores the importance of recognizing atypical presentations of MFS.
- Delayed diagnosis can result from overlapping symptoms with other neurological conditions like stroke.
Implications:
- Accurate and timely diagnosis of MFS is crucial for appropriate treatment and improved patient outcomes.
- Increased awareness of MFS diagnostic criteria can prevent misdiagnosis and inappropriate therapeutic interventions.
