scholarly journals Miller-Fisher Syndrome and Guillain-Barre Syndrome overlap syndrome in a patient post Oxford-AstraZeneca SARS-CoV-2 vaccination

2021 ◽  
Vol 14 (11) ◽  
pp. e246701
Author(s):  
Yew Li Dang ◽  
Alexander Bryson
Keyword(s):  
Overlap Syndrome ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Oculomotor Nerve Palsy ◽  
Limb Weakness ◽  
Patient Counselling ◽  
Fisher Syndrome ◽  
Facial Diplegia ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

We describe a patient who developed bilateral oculomotor nerve palsy, ataxia, facial diplegia and lower limb weakness 2 weeks post-Oxford-AstraZeneca SARS-CoV2 vaccination, consistent with Miller-Fisher syndrome (MFS) and Guillain-Barre syndrome (GBS) overlap syndrome. Although some features of the patient’s presentation were typical of recently reported cases of a rare GBS variant post-Oxford-AstraZeneca vaccination, including severe facial weakness and a lack of respiratory involvement, to our knowledge this is the first reported case of MFS associated with SARS-CoV2 vaccination. While postvaccination GBS remains rare, it appears to have a favourable prognosis, and recognising this entity is therefore important for patient counselling and monitoring for potential complications.

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.

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 Faster Recovery of Internal Ophthalmoplegia than External Ophthalmoplegia in a Miller Fisher Variant of Guillain-Barre Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Golla Abhinav ◽  
Jorge Gamez ◽  
Michael C. Yang ◽  
Tetyana Vaysman ◽  
Michelle von Gunten ◽  
...  
Keyword(s):  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
The Difference ◽  
Guillain Barré

We present a case of classic Miller Fisher Syndrome (MFS) variant of Guillain-Barre Syndrome (GBS) with detailed description in the difference between the internal and external ophthalmoplegia. They are different in their onset, duration, and recovery.

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