Vol.101 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 9 September 2008
A Case of Miller-Fisher Syndrome
Yoshiya Ishida and Atsuyoshi Asahi
(Kitami Red Cross Hospital, Asahikawa Medical College)
Tetsuji Wada and Naoki Kanai
(Kitami Red Cross Hospital)
Yuuki Kobayashi and Yasuaki Harabuchi
(Asahikawa Medical College)
Takeshi Kanaya
(Hokkaido Social Insurance Hospital)
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-nystagmograph, 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.
Key words :Miller-Fisher syndrome, dizziness and double vision, anti-GQ1b antibody