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Miller Fisher syndrome: a diagnosis not to be missed

Published online by Cambridge University Press:  23 March 2007

S J Davis ,
R Salib ,
H Buchan  and
E Nilssen
S J Davis*
Affiliation:
Departments of Otorhinolaryngology, Portsmouth, UK
R Salib
Affiliation:
Departments of Otorhinolaryngology, Portsmouth, UK
H Buchan
Affiliation:
Medicine, Queen Alexandra Hospital, Portsmouth, UK
E Nilssen
Affiliation:
Departments of Otorhinolaryngology, Portsmouth, UK
*
Address for correspondence: Mr S J Davis, 106 Nibley Road, Shirehampton, Bristol BS11 9XW, UK. Fax: 0117 9595850 E-mail: sd4166@hotmail.com
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Abstract

We report a case of Miller Fisher syndrome presenting in an ENT setting. The referral was made on the basis of worsening nasal regurgitation following Campylobacter jejuni enteritis. The aim of this report is not to add to the recorded instances of Miller Fisher syndrome, but to help raise the level of its awareness amongst otolaryngologists. Emphasis is placed on the mode of presentation and management issues, as early diagnosis is crucial and confers a favourable prognosis. In that respect, we consider this case noteworthy and instructive.

Keywords

Miller Fisher SyndromeDysphagiaPolyneuropathyCampylobacter Jejuni
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 82 - 85
Copyright
Copyright © JLO (1984) Limited 2007

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References

1Fisher, CM. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N Engl J Med 1956;255:57–65Google Scholar
2Overell, JR, Willison, HJ. Recent developments in Miller Fisher syndrome and related disorders. Curr Opin Neurol 2005;18:562–6CrossRefGoogle ScholarPubMed
3Ito, M, Odaka, M, Koga, M, Hirata, K, Yuki, N. Clinical features and treatment of Fisher syndrome [in Japanese]. Rinsho Shinkeigaku 2005;45:514–17Google ScholarPubMed
4Chiba, A, Kusunoki, S, Obata, H, Machinami, R, Kanazawa, I. Ganglioside composition of the human cranial nerves, with special reference to pathophysiology of Miller Fisher syndrome. Brain Res 1997;745:32–6Google Scholar
5Yuki, N, Taki, T, Takahashi, M, Saito, K, Yoshino, H, Tai, T et al. Molecular mimicry between GQ1b, ganglioside and lipopolysaccharides of Campylobacter jejuni isolated from patients with Fisher's syndrome. Ann Neurol 1994;36:791–3Google Scholar
6Koga, M, Gilbert, M, Li, J, Koike, S, Takahashi, M, Furukawa, K et al. Antecedent infections in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology 2005;64:1605–11CrossRefGoogle ScholarPubMed
7Goodyear, CS, O'Hanlon, GM, Plomp, JJ, Wagner, ER, Morrison, I, Veitch, J et al. Monoclonal antibodies raised against Guillain-Barré syndrome-associated Campylobacter jejuni lipopolysaccharides react with neuronal gangliosides and paralyze muscle-nerve preparations. J Clin Invest 1999;104:697–708CrossRefGoogle ScholarPubMed
8Halstead, SK, O'Hanlon, GM, Humphreys, PD, Morrison, DB, Morgan, BP, Todd, AJ et al. Anti-disialoside antibodies kill perisynaptic Schwann cells and damage motor nerve terminals via membrane attack complex in a murine model of neuropathy. Brain 2004;127:2109–23Google Scholar
9O'Hanlon, GM, Plomp, JJ, Chakrabarti, M, Morrison, I, Wagner, ER, Goodyear, CS et al. Anti-GQ1b ganglioside antibodies mediate complement-dependent destruction of the motor nerve terminal. Brain 2001;124:893–906CrossRefGoogle ScholarPubMed
10Hughes, RA, Cornblath, DR. Guilain-Barre syndrome. Lancet 2005;366:1653–66Google Scholar
11Meythaler, JM. Rehabilitation of Guillain-Barré syndrome. Arch Phys Med Rehabil 1997;78:872–9CrossRefGoogle ScholarPubMed
12Guiloff, RJ. Peripheral nerve conduction in Miller Fisher syndrome. J Neurol Neurosurg Psychiatry 1977;40:801–7CrossRefGoogle ScholarPubMed
13Fross, RD, Daube, J. Neuropathy in the Miller-Fisher syndrome: clinical and electrophysiologic findings. Neurology 1987;37:1493–8Google Scholar
14Battaglia, F. Recurrent Miller-Fisher syndrome. Rev Neurol (Paris) 2005;161:844–7Google Scholar
15The Guillain-Barré Syndrome Study Group. Plasmapheresis and acute Guillain-Barré syndrome. Neurology 1985;35:1096–104Google Scholar
16McKhann, GM, Griffin, JW, Cornblath, DR, Mellits, ED, Fisher, RS, Quaskey, SA. Plasmapheresis and Guillain-Barré syndrome: analysis of prognostic factors and the effect of plasmapheresis. Ann Neurol 1988;23:347–53CrossRefGoogle ScholarPubMed
17French Cooperative Group on plasma exchange in Guillain-Barré syndrome. Appropriate number of plasma exchanges in Guillain-Barré syndrome. Ann Neurol 1997;41:298–306CrossRefGoogle Scholar
18Espérou, H, Jars Guincestre, MC, Bolgert, F, Raphael, JC, Durand-Zaleski, I, French Cooperative Group on plasma exchange in Guillain-Barré syndrome. Cost-effectiveness of plasma exchange therapy for the treatment of Guillain-Barré syndrome. Intensive Care Med 2000;26:1094–100Google Scholar
19Hughes, RA, Raphael, C, Swan, AV, van Doom, PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2001;2:CD002063Google Scholar
20Hughes, RAC, Wijdicks, E, Barohn, RJ. Practice parameter: immunotherapy for Guillain-Barré syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2003;61:736–40CrossRefGoogle Scholar
21Dalakas, MC. Intravenous immunoglobulin in autoimmune neuromuscular diseases. JAMA 2004;291:2367–75CrossRefGoogle ScholarPubMed
22Korinthenberg, R, Schessl, J, Kirschner, J, Montning, JS. Intravenous immunoglobulin in the treatment of childhood Guillain-Barré syndrome. Pediatrics 2005;116:226–8CrossRefGoogle ScholarPubMed
23Farcas, P, Avnun, L, Herishanu, YO, Wirguin, I. Efficacy of repeated intravenous immunoglobulin in severe unresponsive Guillain-Barré syndrome. Lancet 1997;350:1747Google Scholar
24Willison, HJ, Townson, K, Veitch, J, Boffrey, J, Issacs, N, Andersen, SM et al. Synthetic disialylgalactose immunoadsorbents deplete anti-GQ1b antibodies from autoimmune neuropathy sera. Brain 2004;127:680–91Google Scholar
25Hughes, RAC, van der Meche, FG. Corticosteroids for treating Guillain-Barré syndrome. Cochrane Database Syst Rev 2000;2:CD001446Google Scholar
26Rich, MM, Pinter, MJ, Craner, SD, Barchi, RL. Loss of electrical excitability in an animal model of acute quadriplegic myopathy. Ann Neurol 1998;43:171–9CrossRefGoogle Scholar
27Pritchard, J, Gray, IA, Idrissova, ZR, Lecky, BR, Sutton, IJ, Swan, AV et al. A randomized controlled trial of recombinant interferon-beta 1a in Guillain-Barré syndrome. Neurology 2003;61:1282–4Google Scholar
28Bechtold, DA, Yue, X, Evans, RM, Davies, M, Gregson, NA, Smith, KJ. Axonal protection in experimental autoimmune neuritis by the sodium channel blocking agent flecainide. Brain 2005;128:18–28CrossRefGoogle ScholarPubMed
29Merkies, IS, Schmitz, PI, Samijn, JP, van der Meché, FG, van Doom, PA. Fatigue in immune-mediated polyneuropathies. European Inflammatory Neuropathy Cause and Treatment (INCAT) Group. Neurology 1999;53:1648–54Google Scholar
30Bernsen, AJAM, De Jager, AEJ, Schmitz, PIM, van der Meché, FGA. Long-term impact on work and private life after Guillain-Barré syndrome. J Neurol Sci 2002;201:13–17Google Scholar
31Bickerstaff, ER, Cloake, PC. Mesencephalitis and rhombencephalitis. BMJ 1951;2:77–81Google Scholar
32Odaka, M, Yuki, N, Yamada, M, Koga, M, Tagemi, T, Hirata, K et al. Bickerstaff's brainstem encephalitis: clinical features of 62 cases and a subgroup associated with Guillain-Barre syndrome. Brain 2003;126:2279–90Google Scholar