Solmaz, Volkan Gaziosmanpaşa University - School of Medicine - Department of Neurology, Turkey , Aksoy, Dürdane Gaziosmanpaşa University - School of Medicine - Department of Neurology, Turkey , Çevik, Betül Gaziosmanpaşa University - School of Medicine - Department of Neurology, Turkey , Kurt, Semiha Gaziosmanpaşa University - School of Medicine - Department of Neurology, Turkey , Çevik, Emre Gaziosmanpaşa University - School of Medicine - Department of Neurology, Turkey , Pekdaş, Elmas Gaziosmanpaşa University - School of Medicine - Department of Neurology, Turkey

A case of Miller Fisher syndrome with progression and early relapse

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Miller Fisher syndrome (MFS) is one of the rare variants of the Guillain-Barre syndrome. Charles Miller Fisher expressed the disease to be a Guillain-Barre variant with a good prognosis, that is accompanied by ataxia, ophthalmoplegia and areflexia. While it is generally monophasic, some cases with recurrences were also reported in literature. This article presents a 73-year-old male patient who was admitted to our clinic with ataxia, ophthalmoplegia, areflexia and paresthesia. No abnormality was detected in the complete blood count, routine biochemistry, erythrocyte sedimentation rate, C-reactive protein, thyroid function tests and serum vitamin B12 and folate levels, tests for hepatitis A, B and other viral markers; brain and cervical magnetic resonance images (MRI) were also normal. Electroneurography revealed the absence of the median, ulnar, peroneal and the tibial F waves. Anti-GQ1b antibody was positive in the patient s serum. He was hospitalized with the diagnosis of MFS, and he subsequently developed tetraparesis in the following a few days, and had a relapse in the early period. Seven-day intravenous immunoglobulin (IVIG) treatment which was given to the patient after hospitalization, was repeated upon the patient’s relapse on the 30th day of his admission. A partial recovery of the patient’s symptoms was observed after these treatments. Although there have been studies suggesting that the prognosis of MFS is good, progression or early relapses can be seen during the course of the disease; and as in this case, the repeated IVIG treatment can affect the course of the disease positively. Therefore, it is important to keep these rare conditions in mind during follow-up of patients diagnosed with MFS.

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Miller Fisher Syndrome , Guillain , Barre Syndrome , Intravenous immunoglobulin

Cumhuriyet Medical Journal

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