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2014, Number 2

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Rev Med UV 2014; 14 (2)

Miller-Fisher´s Syndrome, a case report

Escutia CHH, Padilla TB, Soto MJ, Zamudio RA

Language: Spanish
References: 32
Page: 27-32
PDF size: 265.19 Kb.


ABSTRACT

Introduction: The Miller-Fisher´s Syndrome is an acute, autoimmune, demyelinating disease caused by the affection of cranial and peripheral nerves, considered a clinical variant of Guillain-Barré Syndrome, which is the most common variant . There is a history of an infection that precedes symptoms by 43 to 60 % of cases, associated with Campylobacter jejuni, H. influenzae, Cytomegalovirus, etc. Classically characterized by ophthalmoplegia, ataxia and areflexia. Diagnosis is based on clinical suspicion coupled with the determination of specific ganglioside antibodies and other laboratory and cabinet tests. Objectve: Report the first confirmed case of this condition in the state of Veracruz and publicize the clinical features of this demyelinating polyradiculoneuropathy. Case Report. A 34 year old woman with a history of abdominal pain, fever and diarrhea twenty days before, which resolved spontaneously. It began with binocular diplopia, accompanied by dizziness, nausea and prostration. A day later, generalized and ascending dysesthesia, which progressed within 24 hours to progressive generalized muscle weakness, areflexia and bilateral areflectic ophthalmoplegia. Results: Study of anti-ganglioside antibodies positive to GM3 and GQ1b, Electromyography supporting polyradiculoneuropathy. Conclusion: This is the first report of a confirmed case of this pathology performed in a hospital in the state of Veracruz.


REFERENCES

  1. Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T. Clinical features and prognosis of Miller Fisher syndrome. Neurology 2001; 56:1104-6.

  2. Koga M, Gilbert M, Li J. Antecedent infections in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology 2005; 64:1605-11.

  3. Asbury A, Arnason B, Adams R. The inflammatory lesion in idiopathic polyneuritis: its role in pathogenesis. Medicine (Baltimore) 1969; 48:173-215.

  4. Hafer-Macko C, Sheikh K, Li J. Immune attack on the Schwann cell surface in acute inflammatory demyelinating polyneuropathy. Ann Neurol 1996; 39:625-35.

  5. Sekiguchi Y, Uncini A, Yuki N. Antiganglioside antibodies are associated with axonal Guillain-Barré syndrome: a Japanese-Italian collaborative study. J Neurol Neurosurg Psychiatry 2012; 83:23-8.

  6. Capasso M, Notturno F, Mazoli C, Uncini A. Involvement of sensory fibers in axonal subtypes of Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 2011; 82:664-70.

  7. Ito M, Kuwabara S, Odaka M. Bickerstaff’s brainstem encephalitis and Fisher syndrome form a continuous spectrum: clinical analysis of 581 cases. J Neurol 2008; 255:674-82.

  8. Ito M, Matsuno K, Sakumoto Y, Hirata K, Yuki N. Ataxic Guillain-Barré syndrome and acute sensory ataxic neuropathy form a continuous spectrum. J Neurol Neurosurg Psychiatry 2011; 82:294-9.

  9. Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Serum anti- GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain-Barré syndrome: clinical and immunohistochemical studies. Neurology 1993; 43:1911-7.

  10. Liu J, Willison H, Pedrosa-Domellof F. Immunolocalization of GQ1b and related gangliosides in human extraocular neuromuscular junctions and muscle spindles. Invest Ophthalmol Vis Sci 2009; 50:3226-32.

  11. Koga M, Yoshino H, Morimatsu M, Yuki N. Anti-GT1a IgG in Guillain- Barré syndrome. J Neurol Neurosurg Psychiatry 2002; 72:767-71.

  12. Koga M, Gilbert M, Li J. Antecedent infections in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology 2005; 64:1605-11.

  13. Yuki N, Taki T, Inagaki F. A bacterium lipopolysaccharide that elicits Guillain-Barré syndrome has a GM1 ganglioside- like structure. J Exp Med 1993; 178:1771-5.

  14. Houliston RS, Koga M, Li J. A Haemophilus influenzae strain associated with Fisher syndrome expresses a novel disialylated ganglioside mimic. Biochemistry 2007; 46:8164-71.

  15. Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T. Clinical features and prognosis of Miller Fisher syndrome. Neurology 2001; 56 (8): 1104-6.

  16. San-Juan O, Martínez-Herrera J, García J, Gonzalez-Aragon M, Del Castillo- Calcáneo J, Pérez-Neri I. Miller Fisher syndrome: 10 years’ experience in a third-level center. Eur Neurol 2009; 62 (3): 149-154.

  17. Santos E, Cabrera E, Flores E, Jiménez M, Hernández R, San Juan D, et al. Síndrome de Miller Fisher. Arch Neurocien (Mex) 2007; 12 (3): 180-182.

  18. Yuan CL, Wang YJ, Tsai CP. Miller Fisher syndrome: a hospital-based retrospective study. Eur Neurol 2000; 44 (2): 79-85.

  19. Hughes R, Wijdicks E, Benson E. Supportive care for patients with Guillain-Barré syndrome. Arch Neurol 2005; 62:1194-8.

  20. Van Doorn P, Ruts L, Jacobs B. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol 2008; 7:939-50.

  21. Ropper A. The Guillain-Barré syndrome. N Engl J Med 1992; 326:1130- 6.

  22. Graham R, Hughes R, White C. A prospective study of physiotherapist prescribed community based exercise in inflammatory peripheral neuropathy. J Neurol 2007; 254:228-35.

  23. Khan F, Amatya B, Brand C, Turner-Stokes L. Multidisciplinary care for Guillain-Barré syndrome. Eur J Phys Rehabil Med 2011; 47:607-12.

  24. Ruts L, Drenthen J, Jongen J. Pain in Guillain-Barré syndrome: a longterm follow-up study. Neurology 2010; 75:1439-47.

  25. Ruts L, van Koningsveld R, Jacobs B, van Doorn P. Determination of pain and response to methylprednisolone in Guillain- Barré syndrome. J Neurol 2007; 254:1318-22.

  26. Garssen M, van Koningsveld R, van Doorn P. Residual fatigue is independent of antecedent events and disease severity in Guillain- Barré syndrome. J Neurol 2006; 253:1143-6.

  27. Kuitwaard K, de Gelder J, Tio-Gillen A. Pharmacokinetics of intravenous immunoglobulin and outcome in Guillain-Barré syndrome. Ann Neurol 2009; 66:597-603.

  28. Farcas P, Avnun L, Frisher S, Herishanu Y, Wirguin I. Efficacy of repeated intravenous immunoglobulin in severe unresponsive Guillain-Barré syndrome. Lancet 1997; 350:1747.

  29. Guillain-Barré Syndrome Steroid Trial Group. Double-blind trial of intravenous methylprednisolone in Guillain-Barré syndrome. Lancet 1993; 341:586-90.

  30. Hughes R, Newsom-Davis J, Perkin G, Pierce J. Controlled trial prednisolone in acute polyneuropathy. Lancet 1978; 2:750-3.

  31. Van Koningsveld R, Schmitz P, van der Meché F. Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barré syndrome: randomized trial. Lancet 2004; 363:192-6.

  32. Mori M, Kuwabara S, Fukutake T, Hattori T. Intravenous immunoglobulin therapy for Miller Fisher syndrome. Neurology 2007; 68:1144-6.




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