scholarly journals A rare mimic of acute stroke: rapidly progressing Miller-Fisher Syndrome to acute motor and sensory axonal neuropathy variant of Guillain-Barre Syndrome

2019 ◽  
Vol 12 (3) ◽  
pp. e228220
Author(s):  
Lennie Lynn Chua de Castillo ◽  
Jose Danilo Bengzon Diestro ◽  
Katrina Hannah Dizon Ignacio ◽  
Paul Matthew Dimaguila Pasco
Keyword(s):  
Early Recognition ◽  
Axonal Neuropathy ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Fisher Syndrome ◽  
Brainstem Stroke ◽  
Guillain Barré Syndrome ◽  
Initial Onset ◽  
Clinical Triad ◽  
Guillain Barré

Ophthalmoplegia, ataxia and areflexia characterise the clinical triad of Miller-Fisher Syndrome (MFS). When the disease presents acutely, it can mimic posterior circulation stroke. We describe a case of an adult patient presenting with sudden dizziness, diplopia, vomiting, and loss of balance. She was initially managed as a case of a brainstem stroke, but the progression of craniopathies without deterioration in sensorium coupled with areflexia clinched the diagnosis of MFS two days into her admission. On the third day, her MFS progressed rapidly to acute motor and sensory axonal neuropathy (AMSAN) variant of Guillain-Barre Syndrome, a rare occurrence in patients with MFS, with only four reported cases including our own. Among the four cases, ours is the only one still non-ambulatory eight months after the initial onset of symptoms. The case highlights the importance of early recognition of MFS in patients with ophthalmoplegia and ataxia despite initially normal reflexes.

scholarly journals An Overlapping Case of Miller Fisher Syndrome, Bickerstaff’s Encephalitis, and the ASMAN Variant of Guillain-Barre Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
E. J. Pegg ◽  
S. K. Chhetri ◽  
U. G. Lekwuwa ◽  
T. Majeed
Keyword(s):  
Axonal Neuropathy ◽  
Sensory Neuropathy ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Igg Antibody ◽  
Limb Weakness ◽  
Fisher Syndrome ◽  
Bickerstaff’S Brainstem Encephalitis ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

A 56-year-old man presented with a 3-day history of progressive tingling of the hands, unsteadiness, and diplopia. He was initially diagnosed clinically with Miller Fisher Syndrome (MFS) but later developed limb weakness consistent with Guillain-Barre Syndrome (GBS) and subsequently reduced consciousness consistent with Bickerstaff’s brainstem encephalitis (BBE). Neurophysiology revealed an axonal motor and sensory neuropathy, in keeping with the Acute Motor and Sensory Axonal Neuropathy (AMSAN) variant of GBS. We believe that our patient had an MFS-AMSAN-BBE overlap syndrome. This is supported by his glycolipid antibody profile with high titres of anti-GQ1b IgG antibody and anti-GD1a IgG antibody. Anti-GQ1b antibodies are frequently found in both MFS and BBE and the anti-GD1a antibody is associated with axonal forms of GBS. Overlapping cases of MFS and BBE are well described, and because the same antibody is often found in both conditions, it is thought that they share a common autoimmune mechanism. BBE has also been previously reported in association with GBS lending support that it also lies on the same spectrum. This overlapping case of ASMAN variant of GBS, MFS, and BBE provides further support that these conditions are part of the same spectrum.

scholarly journals An Overlapping Case of Miller Fisher Syndrome and the Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome

2020 ◽  
Author(s):  
Hélio Martins ◽  
Joana Mendonça ◽  
David Paiva ◽  
Carlos Fernandes ◽  
Jorge Cotter
Keyword(s):  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Magnetic Resonance Angiogram ◽  
Blurred Vision ◽  
Fisher Syndrome ◽  
Medicine Department ◽  
Neurological Improvement ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Head Computed Tomography

A 55 years-old Caucasian male presented initially in the emergency room reporting myalgia, chills and fever. Physical exam and laboratory tests were unremarkable and he was discharged with symptomatic care. He returned to our ER two weeks later reporting dizziness, loss of balance, blurred vision, mild dysarthria and bilateral hand paresthesia. On examination he presented complete bilateral ophthalmoplegia, mild dysarthria, left finger-to-nose dysmetria, ataxia, areflexia and bilateral hand hypoesthesia without fever. Blood tests and head computed tomography were normal. The patient was admitted to the Internal Medicine department. On second day inwards the patient presented dysphagia. Head magnetic resonance angiogram showed no signs of ischemia or vascular disease and a lumbar puncture was performed but no pleocytosis, albumin-cytological dissociation or hypoglycorrhachia was present. Despite the normal results we suspected of a Guillain–Barré syndrome variant, and started treatment with intravenous immunoglobulin (IVIG) in a dose of 400mg per kilogram and continued for five days with immediate neurological improvement. We present a rare overlapping case of Miller Fisher syndrome and Pharyngeal-Cervical-Brachial variant of Guillain–Barré syndrome.

Acute Motor Axonal Neuropathy in a 5-Month-Old Child

2019 ◽  
Vol 18 (03) ◽  
pp. 171-174
Author(s):  
Federica Sullo ◽  
Milena Motta ◽  
Pierluigi Smilari ◽  
Luigi Rampello ◽  
Filippo Greco ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Male Infant ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Prior Infection ◽  
Prevalent Form

AbstractGuillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy characterized by rapidly progressive, essentially symmetric weakness and areflexia in a previously otherwise healthy child. It is the most common cause of acute flaccid paralysis in children, and its reported incidence is 1 to 2/100,000 population. Prior infection is a well-established predating event in GBS. The commonly recognized variants of GBS are acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy, and Miller–Fisher syndrome. AIDP is the most prevalent form. As Guillain–Barrè syndrome represents an important differential diagnosis in infancy with pronounced and progressive hypotonia, we herein report a case of AMAN in a 5-month-old male infant without known exposure to immunomodulating factors or infections.

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.

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