Miller Fisher syndrome with sinus arrest

Shiraiwa, Nobuko; Umesawa, Mitsumasa; Hoshino, Sachiko; Enomoto, Tsuyoshi; Kusunoki, Susumu; Tamaoka, Akira; Ohkoshi, Norio

doi:10.4081/ni.2017.7312

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Neurol Int

2017

DOI: 10.4081/ni.2017.7312

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Miller Fisher syndrome with sinus arrest

Nobuko Shiraiwa

Mitsumasa Umesawa

Sachiko Hoshino

et al.

Abstract: Dysautonomia in Guillain-Barre syndrome (GBS) rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS) is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A mag… Show more

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Cited by 3 publications

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Autonomic involvement in Guillain–Barré syndrome: an update

2018

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Autonomic involvement in Guillain–Barré syndrome: an update

2018

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Use of pacemaker in GBS dysautonomia

Abbas

Sardar

2021

BMJ Case Rep

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Autonomic dysfunction in Guillain-Barrè syndrome (GBS) involves labile hypotension, hypertension, resting tachycardia and sweating. While autonomic involvement affects 66% of patients with GBS, the changes are usually transient and reversible. We hereby delineate a case of a female who presented to our medical centre with flaccid, painless progressive quadriparesis with features of dysautonomia. She had resting tachycardia, was tachypneic with reduced chest expansion and required immediate invasive mechanical ventilation. After pertinent laboratory evaluation, nerve conduction studies were promptly performed at the bedside and findings were concordant with acquired acute inflammatory demyelinating polyneuropathy. The diagnosis of GBS was made on the standard set of investigations and plasmapheresis was initiated on the same day. Her intensive care unit stay was complicated by the multiple episodes of asystole. Even though a temporary transvenous pacemaker was inserted, she, unfortunately, succumbed to a sudden episode of asystole. This paper illustrates that GBS-associated autonomic dysfunction can be severe and close cardiac monitoring is imperative in these patients.

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Recent Concepts of Guillain-Barré Syndrome

Yoon¹,

Bae²,

Kim³

2019

J Korean Neurol Assoc

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Guillain-Barré syndrome (GBS) is a representative form of post-infectious autoimmune neuropathy with heterogenous manifestations. It was originally considered as an ascending demyelinating polyneuropathy in Western countries. However, the discovery of anti-ganglioside antibodies on the basis of molecular mimicry theory could help us better understand various kinds of focal and regional variants as well as axonal type of GBS those were frequently found from Asian countries. Recent development of new techniques about anti-ganglioside complex antibodies is making more detailed descriptions for specific or unusual clinical manifestations. It has been regarded that GBS has good prognosis if treated properly as early as possible, but it still shows high mortality and morbidity rate with frequent long term neurologic and medical complications. Unfortunately, there are only two options for medical treatment, intravenous immunoglobulin and plasmapheresis, for the last 100 years. Several clinical studies on new immunotherapy targeting complement activating system with background of molecular mimicry using animal model are underway. We hope that these new treatments will be helpful for the future patients.

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Miller Fisher syndrome with sinus arrest

Cited by 3 publications

References 8 publications

Autonomic involvement in Guillain–Barré syndrome: an update

Autonomic involvement in Guillain–Barré syndrome: an update

Use of pacemaker in GBS dysautonomia

Recent Concepts of Guillain-Barré Syndrome

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