Miller Fisher syndrome with presynaptic neuromuscular transmission disorder

J Clin Neurosci. 2014 Nov;21(11):2025-7. doi: 10.1016/j.jocn.2014.05.050. Epub 2014 Oct 7.

Abstract

Miller Fisher syndrome is defined by a triad of symptoms, namely areflexia, ataxia, and ophthalmoparesis. The ophthalmoparesis is mostly severe, undulating weakness of eye movements with ptosis and increased fatigability resembling a neuromuscular transmission disorder. We present a 52-year-old man with severe Miller Fisher syndrome with a high level of anti-GQ1b antibodies and a presynaptic type of neuromuscular transmission disorder. The diagnosis was confirmed by stimulated single-fiber electromyography with the use of a concentric needle electrode and various stimulation rates.

Keywords: Fisher syndrome; Neuromuscular transmission disorder; Ophthalmoparesis; Single-fiber electromyography.

Publication types

  • Case Reports

MeSH terms

  • Ataxia / etiology
  • Autoantibodies / blood*
  • Diplopia / etiology
  • Electromyography* / methods
  • Evoked Potentials, Somatosensory
  • Gangliosides / immunology*
  • Humans
  • Male
  • Middle Aged
  • Miller Fisher Syndrome / complications
  • Miller Fisher Syndrome / diagnosis*
  • Miller Fisher Syndrome / immunology
  • Miller Fisher Syndrome / physiopathology
  • Neuromuscular Junction Diseases / complications*
  • Neuromuscular Junction Diseases / physiopathology
  • Ophthalmoplegia / etiology
  • Reflex, Abnormal

Substances

  • Autoantibodies
  • Gangliosides
  • GQ1b ganglioside