Progressive subacute Miller-Fisher syndrome successfully treated with plasmapheresis

Neurol Neurochir Pol. 2015;49(2):137-8. doi: 10.1016/j.pjnns.2015.03.002. Epub 2015 Mar 12.

Abstract

Background: Miller-Fisher Syndrome (MFS) is a rare acute polyneuropathy composed of the clinical triad of ataxia, areflexia and ophthalmoplegia, with a monophasic, self-limited course and spontaneous improvement.

Case report: The authors present a 65-year-old man with Miller-Fisher syndrome consisting of bilateral ophthalmoplegia, trigeminal and facial nerve palsy, mild ataxia and peripheral neuropathy. The disease had a progressive, subacute course within 3 months. A high titer of anti-GQ1b antibodies was detected. As a result of plasmapheresis, complete recovery was achieved.

Conclusions: The presented case was atypical in its clinical course and treatment. It could support the theory of the continuity between MFS, Bickerstaff brainstem encephalitis (BBE), and Guillain-Barré syndrome (GBS).

Keywords: Anti-GQ1b antibody; Miller-Fisher syndrome; Plasmapheresis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies / immunology
  • Autoantibodies / isolation & purification
  • Gangliosides / immunology
  • Humans
  • Male
  • Miller Fisher Syndrome / therapy*
  • Plasma Exchange
  • Plasmapheresis / methods*
  • Treatment Outcome

Substances

  • Autoantibodies
  • Gangliosides
  • GQ1b ganglioside