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Background:
Miller Fisher syndrome is a variant of acute inflammatory demyelinating polyneuropathy classically characterized by ataxia, ophthalmoplegia, and areflexia. Miller Fisher syndrome can present with uncommon symptoms such as bulbar, facial, and somatic muscle palsies and micturition disturbance.
Case presentation:
We describe the case o...
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Citations
... Some patients have weakness of the face, tongue, and swallowing muscles, as well as micturition disturbance. Others also develop weakness of the limbs and breathing muscles, and are then considered to have GBS-MFS overlap syndrome [7,8]. ...
Background
Beyond the typical respiratory symptoms associated with novel coronavirus, increasing evidence has been reported of the neurological manifestations affecting both the central and peripheral nervous systems.
Case presentation
We observed a 30-year-old Persian woman developing acute motor sensory axonal neuropathy, a variant of Guillain–Barré syndrome that overlaps Miller Fisher syndrome, 30 days after confirmed coronavirus disease-2019 infection. Our case highlight the rare occurrence of Guillain–Barré syndrome overlapping with Miller Fisher during the coronavirus disease-2019 pandemic. These neurologic manifestations may occur because of an aberrant immune response to coronavirus disease-2019.
Conclusions
The early recognition of Guillain–Barré syndrome symptoms is critical, given the associated severe motor disabilities that may seriously limit the quality of life of these patients. We may still have much to learn about the co-occurrence of Guillain–Barré syndrome and Miller Fisher to improve the quality of life of these patients requiring an accurate evaluation by neurologists.
... A review in the literature identified six accessible case reports describing either GBS or MFS-induced BVCP (see table 1). [6][7][8][9][10][11] Acute clinical features of BVCP such as respiratory distress or hoarseness of voice were the primary presenting symptoms in five of the reported cases. [7][8][9][10][11] Additionally, patients did not have any other neurological abnormalities at the initial presentation. ...
... [6][7][8][9][10][11] Acute clinical features of BVCP such as respiratory distress or hoarseness of voice were the primary presenting symptoms in five of the reported cases. [7][8][9][10][11] Additionally, patients did not have any other neurological abnormalities at the initial presentation. [8][9][10] This in combination with negative laboratory test results, and cross-section images made it difficult to establish a diagnosis in the early stage. ...
Miller Fisher syndrome (MFS), an acute demyelinating neuropathy, is characterised by a triad of areflexia, ataxia and ophthalmoplegia. It is the most common variant of Guillain-Barre Syndrome (GBS). In about 5.6%–7.1% of MFS cases, patients also suffer from progressive motor weakness of the limbs. This condition is termed MFS/GBS overlap syndrome. Whether it is in MFS or GBS, bilateral vocal cord paralysis (BVCP) is a rare manifestation with limited cases reported in the literature. We report an extremely rare case where a 65-year-old man developed BVCP in an MFS/GBS overlap syndrome. We have also reviewed previous case reports in the literature for comparison.
... The anti GT1a antibodies often coexist with anti GQ1B, due to their cross-reactivity [1,15,16]. In our case, the positivity of anti GT1a may be of particular interest as they are commonly detected in pharyngeal-cervical-brachial variant of GBS patients and are associated with bulbar palsy in up to 70% of GBS patients [17,18]. ...
Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS). It is largely a clinical diagnosis based on the classical features of ataxia, areflexia, and opthalmoplegia. Its clinical evolution is most often favorable. However, other neurological signs and symptoms may also be present. Supportive laboratory studies (positivity of antibodies, CSF albumin-cytological dissociation and nerve conduction studies) are useful especially in uncommon presentations. We report a case of a 74-year-old patient who exhibited dysphonia and difficulty to swallowing previously to the classic triad of ataxia, areflexia, and opthalmoplegia, characteristic of MFS. CSF analysis demonstrates an albumin-cytological dissociation. Anti-GTa1 antibodies were found but anti-GQ1b antibodies were negative. The patient has spontaneously and completely recovered after 6 weeks.
... GQ1b-seronegative is reported in a minority of patients (approximately 10 to 17%), and may be related to an insufficient sensitivity method of detection or to the pathogenicity of antibodies against gangliosides other than GQ1b [7]. The anti GT1a antibodies often coexist with anti GQ1B, due to their cross-reactivity [1,10,11]. In our case, the positivity of anti GT1a may be of particular interest as they are commonly detected in pharyngeal-cervical-brachial variant of GBS patients and are associated with bulbar palsy in up to 70% of GBS patients [12,13]. ...
Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS). It is largely a clinical diagnosis based on the classical features of ataxia, areflexia, and opthalmoplegia. Its clinical evolution is most often favorable. However, other neurological signs and symptoms may also be present. Supportive laboratory studies (positivity of antibodies, CSF albumin-cytological dissociation and nerve conduction studies) are useful especially in uncommon presentations. We report a case of a 74-year-old patient who exhibited dysphonia and difficulty to swallowing previously to the classic triad of ataxia, areflexia, and opthalmoplegia, characteristic of MFS. CSF analysis demonstrates an albumin-cytological dissociation but anti-GQ1b antibody were negative. The patient has spontaneously and completely recovered after several weeks.
