Recurrent Miller–Fisher syndrome

Orr, Carolyn; Storey, Catherine E.

doi:10.1016/j.jocn.2003.03.006

Cited by 19 publications

(13 citation statements)

References 14 publications

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“…Some patients had very specific symptoms during subsequent episodes, such as unilateral cranial nerve palsy at the same site. We cannot explain this specific finding, but it could be related to a local susceptibility of neural tissue-related epitopes, as replicated laterality of cranial nerve dysfunction has been described before in MFS 15 16…”

Section: Discussionmentioning

confidence: 76%

Recurrent Guillain-Barre syndrome

Kuitwaard

Koningsveld

Ruts

et al. 2008

Journal of Neurology, Neurosurgery & Psychiatry

124

121

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Background: Guillain-Barré syndrome (GBS) is generally considered to be monophasic, but recurrences do occur in a presently undefined subgroup of patients. Objectives: To determine which subgroup of patients develops a recurrence and to establish whether preceding infections and neurological symptoms are similar in subsequent episodes. Methods: A recurrence was defined as two or more episodes that fulfilled the NINCDS criteria for GBS, with a minimum time between episodes of 2 months (when fully recovered in between) or 4 months (when only partially recovered). Patients with a treatment-related fluctuation or chronic inflammatory demyelinating polyneuropathy with acute onset were excluded. The clinical characteristics of recurrent GBS patients were compared with those of 476 non-recurrent patients. Results: 32 recurrent GBS patients, who had a total of 81 episodes, were identified. The clinical symptoms in a first episode were similar to the following episodes in individual patients, being GBS or its variant Miller Fisher syndrome (MFS) but never both. While neurological symptoms in subsequent episodes were often similar, the severity of the symptoms and the nature of the preceding infections varied. Recurrent patients (mean age 34.2 years) were younger than non-recurrent patients (mean age 46.9; p = 0.001) and more often had MFS (p = 0.049) or milder symptoms (p = 0.011). Conclusions: Genetic or immunological host factors may play an important role in recurrent GBS, since these patients can develop similar symptoms after different preceding infections. Recurrences occur more frequently in patients under 30, with milder symptoms and in MFS.

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Section: Discussionmentioning

confidence: 76%

Recurrent Guillain-Barre syndrome

Kuitwaard

Koningsveld

Ruts

et al. 2008

Journal of Neurology, Neurosurgery & Psychiatry

124

121

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“…Other serious complications reported include coma,97 ballism,118 cardiomyopathy from dysautonomia,124 lactic acidosis,150 and pain 79, 100. Recurrence of MFS,16, 69, 95, 125, 143, 145, 152 sometimes showing different phenotypes at different times, has been well documented 51…”

Section: Clinical Featuresmentioning

confidence: 98%

Clinical and immunological spectrum of the Miller Fisher syndrome

2007

Muscle and Nerve

154

132

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The Miller Fisher syndrome (MFS), characterized by ataxia, areflexia, and ophthalmoplegia, was first recognized as a distinct clinical entity in 1956. MFS is mostly an acute, self-limiting condition, but there is anecdotal evidence of benefit with immunotherapy. Pathological data remain scarce. MFS can be associated with infectious, autoimmune, and neoplastic disorders. Radiological findings have suggested both central and peripheral involvement. The anti-GQ1b IgG antibody titer is most commonly elevated in MFS, but may also be increased in Guillain-Barré syndrome (GBS) and Bickerstaff's brainstem encephalitis (BBE). Molecular mimicry, particularly in relation to antecedent Campylobacter jejuni and Hemophilus influenzae infections, is likely the predominant pathogenic mechanism, but the roles of other biological factors remain to be established. Recent studies have demonstrated the presence of neuromuscular transmission defects in association with anti-GQ1b IgG antibody, both in vitro and in vivo. Collective findings from clinical, radiological, immunological, and electrophysiological techniques have helped to define MFS, GBS, and BBE as major disorders within the proposed spectrum of anti-GQ1b IgG antibody syndrome.

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“…Each episode may be similar in its clinical characteristics as was described in four out of 28 FS patients 39. However, patients can present with different patterns that range in its severity; in two separate case reports, a single patient was noted to develop a BBE pattern of illness (with associated drowsiness and extensor plantars) on the third relapse of her anti-GQ1b antibody syndrome40 whereas in another patient, recovery from the first episode of FS overlapped by GBS was followed by two relapses 2 years apart where the patients exhibited the typical FS phenotype 41…”

Section: Clinical Featuresmentioning

confidence: 99%