scholarly journals Miller Fisher syndrome developed after a previous COVID-19 infection (case report)

2021 ◽  
Vol 11 (2) ◽  
pp. 56-60
Author(s):  
V. A. Malko ◽  
P. V. Klimov ◽  
M. P. Topuzova ◽  
I.  V. Yarush ◽  
K. V. Simakov ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Miller Fisher Syndrome ◽  
Complete Regression ◽  
Speech Impairment ◽  
Fisher Syndrome ◽  
Coronavirus Infection ◽  
Clinical Triad ◽  
Classical Triad

Miller Fisher syndrome is one of the forms of Guillain–Barrе́ syndrome, characterized by a clinical triad that includes ophthalmoplegia, ataxia and areflexia, with the possible addition of moderate peripheral tetraparesis. During the year that has passed since the start of the pandemic of the new coronavirus infection COVID‑19, international publications have presented a few cases of Miller Fisher syndrome, which developed in patients at different times after the COVID‑19 infection – from 3–5 days to 3 weeks. The article presents a description of a clinical case of Miller Fisher syndrome, which occurred with 34‑year‑old man 21 days after the COVID‑19 infection. The clinical manifestations of Miller Fisher syndrome were typical and included diplopia, areflexia, and ataxia. At the beginning of the disease, there was a transient episode of speech impairment in the form of mild dysarthria. Oculomotor disorders predominated in the clinical picture over other components of the classical triad. On the background of treatment with human immunoglobulin G, there was a complete regression of symptoms.This description of Miller Fisher syndrome, which developed after the postponed infection with COVID‑19, is the first in Russia. The presented case demonstrates the ability of the SARS‑CoV‑2 virus to induce the development of an autoimmune disease. Practitioners should take into account the possibility of Miller Fisher syndrome developing in the event of an acute onset of diplopia, ataxia and areflexia in patients after a previous COVID‑19 infection.

scholarly journals Anti-Ganglioside Antibody Negative Miller Fisher Syndrome with Atypical Features: A Case Report

2021 ◽  
Vol 07 (02) ◽  
pp. 26-28
Author(s):  
Naresh Kumar ◽  
Keyword(s):  
Case Report ◽  
Miller Fisher Syndrome ◽  
Serological Marker ◽  
Fisher Syndrome ◽  
Immune Mediated ◽  
Negative Case ◽  
Diagnostic Clue ◽  
Clinical Triad ◽  
Classical Triad ◽  
Symptoms And Signs

Miller Fisher Syndrome (MFS), a variant of Guillain Barre Syndrome (GBS), is an immune-mediated neuropathy presenting with the classical clinical triad of ophthalmoplegia, ataxia, and areflexia. Although the clinical triad is the cardinal diagnostic clue, it can also present with a variety of other atypical neurological symptoms and signs beyond the classical triad. IgG anti-GQ1b antibodies are a powerful serological marker for the diagnosis of MFS, however, they can be absent in 10-15% cases of MFS. Here, we are describing a case of a 55-year old lady with an anti-ganglioside negative case of MFS with ptosis and bulbar palsy, who improved with IVIg.

scholarly journals Clinical Features of Miller-Fisher Syndrome in Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Masanori Ono ◽  
Hideki Sato ◽  
Mayu Shirahashi ◽  
Noriko Tomioka ◽  
Julia Maeda ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pregnant Patient ◽  
Acute Onset ◽  
Accurate Diagnosis ◽  
Miller Fisher Syndrome ◽  
The West ◽  
Fisher Syndrome ◽  
Brainstem Stroke ◽  
Clinical Triad ◽  
Patient’S History

Miller-Fisher syndrome (MFS) is recognized as a variant of Guillain-Barré syndrome (GBS). MFS is a rare disorder that is characterized by the acute onset of ophthalmoplegia, ataxia, and areflexia/hyporeflexia. MFS has a higher incidence in Asia, where the incidence is estimated to be 18%–26% of GBS compared with 3%–5% in the West. The differential diagnosis of MFS includes Wernicke’s encephalopathy (WE) which is characterized by a clinical triad (nystagmus and ophthalmoplegia, mental status changes, and ataxia), myasthenia gravis, and brainstem stroke. The association between MFS and pregnancy has not been reported previously. Here, we describe the clinical features of a pregnant woman in early pregnancy with MFS. This case highlights the fact that it is necessary to establish an accurate diagnosis based on the details from the patient’s history on appropriate complementary testing in a pregnant patient with MFS.

scholarly journals Acute Bilateral Ophthalmoparesis with Pupilary Areflexical Mydriasis in Miller-Fisher Syndrome Treated with Intravenous Immunoglobulin

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Theocharis Papanikolaou ◽  
Cath Gray ◽  
Bernard Boothman ◽  
Gerald Naylor ◽  
George Mariatos
Keyword(s):  
Intravenous Immunoglobulin ◽  
Nerve Palsy ◽  
Rare Condition ◽  
Miller Fisher Syndrome ◽  
Uneventful Recovery ◽  
Fisher Syndrome ◽  
History Of ◽  
Classical Triad ◽  
Fourth Nerve Palsy ◽  
Sixth Nerve

Miller-Fisher syndrome (MFS) is a rare condition characterized by the classical triad of ophthalmoplegia, ataxia, and areflexia (Fisher, 1956). It is considered a variant of Guillain-Barré syndrome (GBS) with which it may overlap, or it can occur in more limited forms. We report a case of a thirty-five-year-old male who presented with a six-day history of diplopia, following a recent chest infection. On examination, he was found to have bilateral sixth nerve palsy, bilateral fourth nerve palsy, bilateral areflexical mydriasis, ataxia and total absence of reflexes. After excluding other conditions, a diagnosis of Miller-Fisher syndrome was made. The patient was administered intravenous immunoglobulin and made an uneventful recovery.

scholarly journals The Differential Diagnosis of Acute Onset Truncal Ataxia: The Importance of Dysgeusia in Miller Fisher Syndrome

2018 ◽  
Vol 57 (14) ◽  
pp. 2057-2060 ◽  
Author(s):  
Tatsuya Ueno ◽  
Ryoya Kimura ◽  
Tomoya Kon ◽  
Rie Haga ◽  
Haruo Nishijima ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Acute Onset ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
Truncal Ataxia

Atypical clinical manifestations of Miller Fisher syndrome

2018 ◽  
Vol 40 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Jae Ho Jung ◽  
Eun Hye Oh ◽  
Jin-Hong Shin ◽  
Dae-Seong Kim ◽  
Seo-Young Choi ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome

scholarly journals Miller Fisher syndrome associated with respiratory failure

2020 ◽  
pp. 173
Author(s):  
Keyword(s):  
Respiratory Failure ◽  
Respiratory Symptoms ◽  
Acute Onset ◽  
Mechanical Support ◽  
Vocal Cords ◽  
Fisher Syndrome ◽  
Clinical Variant ◽  
Progressive Respiratory Failure ◽  
Infectious Illness ◽  
Classical Triad

Miller Fischer syndrome (MFS) is a rare clinical variant of Guillain-Barre syndrome. The diagnosis suspected primarily on clinical trial of areflexia, ophtalmoplegia and ataxia, is confirmed by the mandatory presence of antiganglioside antibodies (anti GQ1b). An acute onset is typical of MFS, beginning with neurological symptoms following a respiratory or digestive infectious illness. The therapeutic options are either the plasmapheresis or the administration of intravenous immunoglobulin (IVIG). Although rare, in certain cases the patients present with respiratory symptoms needing intensive care. We report the case report of a patient which presented with the classical triad of MFS but also with rapid progressive respiratory failure due to bilateral vocal cords palsy and general muscle weakness. He needed respiratory mechanical support. The patient received a treatment by IVIG without any improvement in symptomatology. Eventually he completely recovered and he was discharged from the hospital 3 month later.

scholarly journals Miller Fisher variant of Guillain Barre Syndrome: A Case Report

2016 ◽  
Vol 10 (1) ◽  
pp. 44-45
Author(s):  
Radheshyam Saha ◽  
Suranjit Kumar Saha ◽  
Muhammad Nurul Islam ◽  
Mohammad Rafiqul Kabir ◽  
Aniruddha Mondal ◽  
...  
Keyword(s):  
Case Report ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Acute Onset ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
History Of ◽  
Tendon Reflexes ◽  
Csf Examination

Miller Fisher Syndrome (MFS) is characterized by acute onset of ophthalmoplegia, ataxia and loss of tendon reflexes with relative sparing of strength in the extremities and trunk. Our patient Mr. Akter Sheikh, 40 years male, non diabetic, non hypertensive, presented with generalized weakness and difficulty in walking for 7 days preceded by a history of respiratory tract infection. After clinical and CSF examination, he was diagnosed as a case of Miller-Fisher syndrome. With treatment he improved significantly.Faridpur Med. Coll. J. Jan 2015;10(1): 44-45

scholarly journals Bilateral Angle Narrowing and Acute Myopia Induced by Indapamide: A Case Report

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ana Catarina Pedrosa ◽  
Joana Rodrigues Araújo ◽  
João Paulo Macedo ◽  
Sérgio Estrela Silva ◽  
António Melo ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Pressure Control ◽  
Ultrasound Biomicroscopy ◽  
Acute Onset ◽  
Angle Closure ◽  
Anterior Chamber Angle ◽  
Ciliochoroidal Effusion ◽  
Blurry Vision

Purpose. To describe a clinical case of indapamide induced bilateral angle narrowing and acute myopia. Materials and Methods. Clinical case report. Results. A 37-year-old Caucasian emmetropic man presented to the Emergency Department with complaints of acute-onset bilateral blurry vision, nine days after starting treatment for arterial hypertension with a combination of indapamide and amlodipine. Clinical examination revealed the presence of myopia and appositional closure of the anterior chamber angle. Ultrasound biomicroscopy and mode B ultrasonography disclosed bilateral ciliochoroidal effusion with anterior rotation of the ciliary body and iridocorneal angle narrowing. After intraocular pressure control with brimonidine and timolol, and replacement of indapamide/amlodipine by amlodipine only, the patient was discharged. Complete resolution of the clinical manifestations was observed after three weeks, with no sequelae. Conclusions. Indapamide may cause acute myopia and angle closure secondary to ciliochoroidal effusion that are fully reversible after drug withdrawal, as long as timely diagnosis is established. Therefore, indapamide, as well as other sulfonamide-derived drugs, must always be considered in the differential diagnosis of acute myopia and angle closure.

Acute onset of chronic infl ammatory demyelinating polyneuropathy in combination with COVID-19

2022 ◽  
Vol 26 (6) ◽  
pp. 35-42
Author(s):  
D. R. Safina ◽  
A. R. Safina ◽  
A. M. Gizdatova ◽  
R. G. Esin
Keyword(s):  
Peroneal Nerve ◽  
Clinical Case ◽  
Tibial Nerve ◽  
Pulse Therapy ◽  
Acute Onset ◽  
Demyelinating Polyneuropathy ◽  
Review Of Literature ◽  
Motor Functions ◽  
Demyelinating Lesions ◽  
Coronavirus Infection

Acute onset of chronic infl ammatory demyelinating polyneuropathy (A-CIDP) presents signifi cant diffi culties in differential diagnosis with acute infl ammatory demyelinating polyneuropathy (AIDP). The article presents review of literature about diff erential diagnosis between A-CIDP and AIDP and a clinical case of A-CIDP at 26-year-old man. The disease started after vaccination against infl uenza and an episode of enteritis, the clinical picture matched Guillain–Barré syndrome criteria, according to electromyography data: demyelinating lesion of the left facial nerve, motor and sensory fi bers of the median and ulnar nerves on both sides, demyelinating lesions of motor fi bers of the tibial nerve and peroneal nerve on both sides. Chronic infl ammatory demyelinating polyneuropathy was diagnosed. Lack of eff ect from plasma exchange was the reason for changing the treatment to pulse therapy with prednisolone (with a subsequent transition to a 1 mg/kg dose and further reduction until canceled within 16 weeks). Response to prednisolone — rapid recovery of motor functions, which worsened signifi cantly due to a new coronavirus infection during treatment in the neurology department. Further continuation of prednisolone therapy made it possible to restore motor functions completely, except mild prosopoparesis. At the same time, deep refl exes were absent; no signifi cant EMG dynamics was observed. Considering the eff ect of glucocorticosteroids and lack of positive dynamics on the second electromyography, the patient was diagnosed as A-CIDP.

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