Clinical features and differences of Miller Fisher syndrome in southern China: Retrospective analysis of 72 patients from 13 provinces in southern China

Abstract

Objectives: We aimed to analyze the clinical features of Miller Fisher syndrome (MFS) in southern China and compare it features presenting in other countries. Methods: Medical records of patients with a diagnosis of Guillain-Barré syndrome (GBS) admitted to 31 tertiary hospitals, located in 13 provinces in southern China, from 1 January 2013 to 30 September 2016, were collected and retrospectively reviewed. Results: A total of 72 patients (36 from rural area and 36 from urban area) were enrolled. Their age at onset was 47.42±15.65 years old. Winter (29.2%) and spring (41.7%) were the seasons with the peak incidence of MFS. Thirty-eight (52.8%) patients had a history of upper respiratory tract infection one week before onset, while 4 (5.6%) patients experienced gastrointestinal infections. Among the 65 patients who underwent lumbar puncture, 48 (73.8%) patients exhibited albumincytologic dissociation in the cerebrospinal fluid study. Overall, 83.5% patients presented with limited outward movement of the eye, 64.2% had bilateral symmetrical ophthalmoplegia, and only 25.4% had unilateral ophthalmoplegia. No significant differences were observed between the rural and urban areas, such as age of onset (p=0.777) or sex distribution (p=0.609). Patients with complete ophthalmoplegia were older than those with incomplete ophthalmoplegia ( 64.53±7.69 years vs 43.19±14.40 years, p<0.001). Conclusion: Winter and spring are the peaks of MFS incidence. The incidence is higher in men than in women. The most common pattern of ophthalmoplegia in MFS is bilateral symmetrical ophthalmoplegia, There is no urban-rural difference in MFS in southern China. Patients with complete ophthalmoplegia were older than incomplete ophthalmoplegia. There is no significant difference of MFS between southern China and other East Asian countries.