J Korean Ophthalmol Soc > Volume 58(2); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(2):197-202.
DOI: https://doi.org/10.3341/jkos.2017.58.2.197    Published online February 15, 2017.
The Characteristics and Prognosis of Miller Fisher Syndrome.
Jae Woo Jung, Jong Heon Lee, Jae Ho Jung
Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. jungjaeho@pusan.ac.kr
밀러-피셔 증후군의 임상양상과 치료경과
정재우⋅이종헌⋅정재호
부산대학교 의학전문대학원 양산부산대학교병원 안과학교실
Correspondence:  Jae Ho Jung,
Email: jungjaeho@pusan.ac.kr
Received: 29 September 2016   • Revised: 5 December 2016   • Accepted: 16 January 2017
Abstract
PURPOSE
In the present study, the clinical characteristics and prognosis of patients clinically diagnosed with classic Miller Fisher syndrome were evaluated. METHODS: We retrospectively investigated the clinical and laboratory findings as well as treatment outcomes using the medical records of patients diagnosed with Miller Fisher syndrome. Symptom triad including acute ophthalmoplegia, ataxia, and areflexia were evaluated. RESULTS: This study included 10 patients. Nine patients had antecedent infectious illness which took an average of 11 ± 9.7 days for onset of diplopia from antecedent infectious systemic illness. Seven patients showed bilateral paralytic strabismus. Specifically, 5 patients showed the involvement of vertical and horizontal extraocular muscles. Pupil impairment and blepharoptosis were observed in 4 patients, limb weakness in 3 patients, dysarthria in 3 patients and facial palsy in 1 patient. Two patients showed contrast enhancement of the abducens nerve on brain magnetic resonance imaging (MRI) and 2 patients showed albumin-cell dissociation on cerebrospinal fluid (CSF) analysis. Eight patients had anti-GQ1b antibodies in their blood serum analysis. Six patients were treated with intravenous immunoglobulins and the other patients were observed with regular follow-ups. The duration of diplopia was 2.9 ± 1.2 months in the treatment group and 3.1 ± 1.7 months in the control group (p > 0.05). The duration of ataxia was 1 ± 0.4 months in the treatment group and 1 ± 0.9 months in the control group (p > 0.05). CONCLUSIONS: Miller Fisher syndrome should be considered in patients with antecedent infection; acute ophthalmoplegia, ataxia and areflexia as well as anti-GQ1b antibody can be helpful for diagnosis. Final outcomes in the treated group were not significantly different from the control group and all patients showed good final outcomes.
Key Words: Anti-GQ1b;Bickerstaff's brain stem encephalitis;Miller Fisher syndrome;Ophthalmoplegia


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