Miller Fisher Syndrome - A Case Report

Abstract

Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barre Syndrome. It involves both adults and children and it comprises a classic triad of ophthalmoplegia, ataxia and areflexia which all develop over a period of few days. Male, 55-year-old, presented to the emergency department with headache, difficulty in vision and unsteadiness in walking for 5 days. Neurological examination revealed marked ophthalmoplegia with severe decreased movements on lateral, medial and upward gaze. A global areflexia was present. Lumbar puncture was performed and revealed cytoalbuminologic dissociation in the CSF. The patient was treated with intravenous immune globulin for seven days with positive response. MFS diagnoses is mostly a clinical diagnosis, so an early identification of the disease and treatment with gamma globulin can greatly modify the evolution and allow a more favourable prognosis, even if the actual pathophysiological process involved in this disease is not yet known.