Asian Journal of Case Reports in Medicine and Health

Miller Fischer Syndrome: A Case Report and Review

Arti Muley *

Department of Medicine, PIMSR, Parul University, Waghodia, Gujarat, India.

Bhargav Bhaliya

Department of Medicine, PIMSR, Parul University, Waghodia, Gujarat, India.

Kuldeep Viramgam

Department of Medicine, PIMSR, Parul University, Waghodia, Gujarat, India.

Mit Patel

Department of Medicine, PIMSR, Parul University, Waghodia, Gujarat, India.

*Author to whom correspondence should be addressed.

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Abstract

Guillain–Barre syndrome (GBS) is a rapid-onset weakness caused by the immune syste damaging the peripheral nervous system. Miller Fisher syndrome (MFS) is a variant of GBS characterized by weakness of the eye muscles, abnormalities in coordination, and absent reflexes. The symptoms may develop over the course of hours to a few weeks. Although rare, it has a tendency to recur, mostly affects younger age groups and may have a long duration of course resulting in significant psychological and economical impact. However, it remains a less reported and studied entity. There is a need for a detailed study to provide recommendations for proper diagnosis and management to reduce the morbidity as well as the adverse psychological, social, and economic impact.

Keywords: Guillain-Barre syndrome, peripheral nervous system, intravenous immunoglobulins

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References

Van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, Van Doorn PA. Guillain-barré syndrome: pathogenesis, diagnosis, treatment and prognosis. Nature Reviews. Neurology. 2014;10(8):469-82.

DOI:10.1038/nrneurol.2014.121.

PMID 25023340.

Willison HJ, Jacobs BC, Van Doorn PA. Guillain-Barré syndrome. Lancet. 2016;(8):388(10045): 717–27.

DOI:10.1016/S0140-6736(16)00339 -1.

PMID 26948435.

Yuki N, Hartung HP. Guillain-barré syndrome. The New England Journal of Medicine. 2012;(6):366(24):2294–304.

DOI:10.1056/NEJMra1114525.

PMID 22694000.

Jones HR Jr. Guillain-barré syndrome: perspectives with infants and children. Semin Pediatr Neurol. 2000;7:91.

Beghi E, Kurland LT, Mulder DW, et al. Guillain-barré syndrome. Clinicoepidemiologic features and effect of influenza vaccine. Arch Neurol. 1985; 42:1053–7

Carroll JE, Jedziniak M, Guggenheim MA. Guillain-barré syndrome. Another cause of the floppy infant. Am J Dis Child 1977;131:699–700.

Buchwald B, de Baets M, Luijckx GJ, et al. Neonatal guillain-barré syndrome: blocking antibodies transmitted from mother to child. Neurology 1999; 53:1246.

Patja A, Paunio M, Kinnunen E, et al. Risk of guillain-barré syndrome after measles–mumps–rubella vaccination. J Pediatr 2001;138:250.

Jacobs BC, Hazenberg MP, Van Doorn PA, et al. Cross-reactive antibodies against gangliosides and Campylobacter jejuni lipopolysaccharides in patients with Guillain-Barré or Miller Fisher syndrome. J Infect Dis. 1997;175:729.

Mori M, Kuwabara S, Miyake M, et al. Haemophilus influenzae infection and Guillain-Barré syndrome. Brain. 2000; 123(Pt 10):2171–8.

Kuroki S, Saida T, Nukina M, et al. Campylobacter jejuni strains from patients with guillain-barré syndrome belong mostly to penner serogroup 19 and contain beta-N-acetylglucosamine residues. Ann Neurol. 1993;33:243–7.

Merkx H, De Keyser J, Ebinger G. Miller Fisher syndrome associated with mycoplasma pneumoniae infection: report of a case. Clin Neurol Neurosurg. 1994;96:96–9.

Neisser A, Bernheimer H, Berger T, et al. Serum antibodies against gangliosides and campylobacter jejuni lipopolysaccharides in Miller Fisher syndrome. Infect Immun. 1997;65:4038–42.

Koga M, Yuki N, Tai T, et al. Miller fisher syndrome and hemophilus influenzae infection. Neurology. 2001;57:686–91.

Chida K, Nomura H, Konno H, et al. Recurrent miller fisher syndrome: clinical and laboratory features and HLA antigens. J Neurol Sci. 1999;165:139–43.

Ishii J, Yuki N, Kawamoto M, et al. Recurrent guillain–barré syndrome, miller fisher syndrome and bickerstaff brainstem encephalitis. J Neurol Sci. 2016;364:59–64.

Hughes RA, Wijdicks EF, Barohn R, Benson E, Cornblath DR, Hahn AF, et al. Practice parameter: immunotherapy for Guillain-Barré syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003;61(6):736-40. DOI:10.1212/WNL.61.6.736. PMID 14504313.

Yuki n. Fisher syndrome and bickerstaff brainstem encephalitis (Fisher-bickerstaff syndrome). J Neuroimmunol. 2009;215: 1–9.