A case of Miller-Fisher syndrome

Abstract

The Miller-Fisher syndrome (MFS) is clinically defined by the triad of ataxia, areflexia and ophthalmoplegia. The pathophysiology of MFS involves immunologically mediated central and peripheral processes. We report a thirty-three-year-old male patient with Miller-Fisher syndrome. He initially manifested diarrhea two weeks before onset. He was referred to our clinic with dizziness, double vision and reduced left hand sensation. Physical examination on admission showed diminished eye movements in external directions, areflexia and ataxia. Findings on brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CFS) examination were unremarkable. We analyzed the eye movement using electro-nys-tagmograph, and mild brainstem dysfunction was indicated. Anti-GQ1b antibody was positive in the serum. Thus, we diagnosed this patient as having MFS. Symptoms and neurological dysfunction improved gradually without treatment during the following weeks, and there were no sequelae.