scholarly journals Miller-Fisher Syndrome: A Case Report and Review of the Literature

2020 ◽  
Vol 4 (4) ◽  
pp. 653-655
Author(s):  
Justina Truong ◽  
Jeff Conley ◽  
John Ashurst
Keyword(s):  
Case Report ◽  
Lumbar Puncture ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Autoimmune Response ◽  
Intravenous Immunoglobulin Therapy ◽  
Fisher Syndrome ◽  
Diarrheal Illness ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Neurological complaints are a common presenting symptom seen by the emergency physician. However, the Miller-Fisher variant of Guillain-Barré syndrome is a rare cause of neurological complaints seen in the emergency department. Case Report: A 26-year-old male presented with dysphonia and bilateral hand and feet paresthesia after a recent diarrheal illness. Examination revealed the absence of tricep, brachioradialis, patellar and Achilles tendon reflexes bilaterally, and difficulty with phonation. Lumbar puncture revealed the presence of anti-GQ1b antibodies, and the patient was diagnosed with Miller-Fisher variant of Guillain-Barré. Discussion: Miller-Fisher syndrome is an acute, autoimmune response that typically follows either an upper respiratory or diarrheal illness. Typically associated with dysfunction of cranial nerves three, four, and six, Miller-Fisher syndrome may present with facial paralysis, opthalmoplegia, arefexia, or ataxia. Lumbar puncture with the presence of anti-GQ1b antibodies is indicative. Treatment could include supportive respiratory care, intravenous immunoglobulin therapy, or plasmapheresis. Conclusion: Miller-Fisher syndrome is a rare form of Guillain-Barré syndrome that the emergency provider should include in the differential when faced with a patient with cranial nerve dysfunction.

scholarly journals Miller Fisher syndrome and COVID-19: is there a link?

2020 ◽  
Vol 13 (8) ◽  
pp. e236419 ◽  
Author(s):  
Amanda Ray
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Symptoms ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
The Novel ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Beyond the typical respiratory symptoms and fever associated with severe acute respiratory syndrome, we may still have much to learn about other manifestations of the novel SARS-CoV-2 infection. A patient presented with Guillain-Barré syndrome in China with a concurrent SARS-CoV-2 infection. The following case report looks at a patient presenting with the rare Miller Fisher syndrome, a variant of Guillain-Barré while also testing positive for COVID-19.

scholarly journals Miller Fisher syndrome after hiv infection ( case report and literature review )

2021 ◽  
Author(s):  
Mohamad Ali Hussein ◽  
Bruna Pereira Correia ◽  
Leonardo Valente de Camargo ◽  
Vinicius Aldo Cury ◽  
Juliana Passos ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Hiv Infection ◽  
White Male ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Acute Hiv Infection ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Context: Guillain-Barré syndrome is a polyradiculoneuropathy of heterogeneous manifestations, necessarily presenting progressive appendicular weakness of variable intensity associated with reduction or abolition of deep reflexes. One of its variants is known as Miller Fisher Syndrome (MFS), characterized by ophthalmoparesis, ataxy and areflexia. It usually has, by etiology, immunomediated reactions induced by acute infections, including HIV. Objectives: This report aims to describe a case of MFS with concomitants HIV infection, attended in a tertiary hospital in northern Paraná and compared it with the literature. [1,7] Case report: A 27-year-old white male patient who presented binocular diplopia, dysarthria, dysphagia, generalized hypotonia, myasfasciculations, sensory ataxia and arreflexia, with a score on the Medical Research Council (MRC) muscle strength scale of 54 points. Treatment with empirical intravenous human immunoglobulina ( IVIG ) was performed pending the result of serologies for etiological screening. He was discharged after eleven days of hospitalization with partial symptomatic improvement and results indicative of acute HIV infection. We compared this case with those described in the published literature Discussion: We compared this case with those described in the published literature and given the low incidence found in the literature of patients with the stage of HIV viremia and the opening of the picture of SMF, the concrete pathophysiology itself is still unknown. The mechanism, however, in which the literature proposes in two theories: (1) an autoimmune action against myelin due to abnormal immunoregulation by HIV; (2) direct action of neurotropic strains of HIV-1. [2.3] Our literature review shows that since 1995, cases of associated guillain barré syndrome have already been reported in the course of HIV viremia. Treatment with immunoglobulin at a dose of 400mg / kg / day for 5 days was done and the symptoms improved. [1,4,6,7] Conclusion: It is exposed, then, a case of HIV-induced MFS whose relationship has consistency, temporality, biological plausibility, coherence and analogy compatible with current literature.

scholarly journals A Case Report of Acute Motor and Sensory Polyneuropathy as the Presenting Symptom of SARS-CoV-2

2020 ◽  
Vol 4 (3) ◽  
pp. 352-354 ◽  
Author(s):  
Michael Kopscik ◽  
Barbra Giourgas ◽  
Bradley Presley
Keyword(s):  
Case Report ◽  
Respiratory Illness ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Polymerase Chain Reaction Test ◽  
Initial Symptom ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Sensory Polyneuropathy

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically presents with respiratory illness and fever, however some rare neurologic symptoms have been described as presenting complaints. We report a case of an acute motor and sensory polyneuropathy consistent with Miller-Fisher Syndrome (MFS) variant of Guillain Barre Syndrome (GBS) as the initial symptom. Case Report: A 31-year old Spanish speaking male presents with two months of progressive weakness, numbness, and difficult walking. He had multiple cranial nerve abnormalities, dysmetria, ataxia, and absent lower extremity reflexes. An extensive workup including infectious, autoimmune, paraneoplastic, metabolic and neurologic testing was performed. Initially SARS-CoV-2 was not suspected based on a lack of respiratory symptoms. However, workup revealed a positive SARS-CoV-2 polymerase chain reaction test as well as presence of Anti-Ganglioside – GQ1b (Anti-GQ1b) immunoglobulin G antibodies. Discussion: Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome (GBS) characterized by a triad of ophthalmoplegia, ataxia, and areflexia. The patient’s exam and workup including Anti-GQ1b is consistent with MFS. Conclusion: SARS-CoV-2 infection in patients can have atypical presentations similar to this neurologic presentation. Prompt recognition and diagnosis can minimize the risk of transmission to hospital staff and facilitate initiation of treatment.

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