Miller Fisher syndrome associated with respiratory failure


Miller Fisher syndrome associated with respiratory failure


Frentescu Alexandra1*, Feys Odile2, Mangion Jean-Paul3, Osseman Michel2, Horlait Geoffrey1

1Intensive Care Unit, Catholic University of Louvain, Belgium.
2Neurology Deparment, Catholic University of Louvain, CHU UCL Namur, Avenue du Docteur G. Therasse 1, 5530 Yvoir, Belgium.
3Emergency Department, Catholic University of Louvain, CHU UCL Namur, Avenue du Docteur G. Therasse 1, 5530 Yvoir, Belgium.


Miller Fischer syndrome (MFS) is a rare clinical variant of Guillain-Barre syndrome. The diagnosis suspected primarily on clinical trial of areflexia, ophtalmoplegia and ataxia, is confirmed by the mandatory presence of antiganglioside antibodies (anti GQ1b). An acute onset is typical of MFS, beginning with neurological symptoms following a respiratory or digestive infectious illness. The therapeutic options are either the plasmapheresis or the administration of intravenous immunoglobulin (IVIG). Although rare, in certain cases the patients present with respiratory symptoms needing intensive care. We report the case report of a patient which presented with the classical triad of MFS but also with rapid progressive respiratory failure due to bilateral vocal cords palsy and general muscle weakness. He needed respiratory mechanical support. The patient received a treatment by IVIG without any improvement in symptomatology. Eventually he completely recovered and he was discharged from the hospital 3 month later.


Keywords: Miller Fisher syndrome; Atypical; Dysphonia; Respiratory failure


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How to cite this article:

Frentescu Alexandra, Feys Odile, Mangion Jean-Paul, Osseman Michel, Horlait Geoffrey. Miller Fisher syndrome associated with respiratory failure. International Journal of Case Reports, 2020; 4:173. DOI: 10.28933/ijcr-2020-09-3005


References:

1. C. Fisher, “An unusual variant of acute idiopathic polyuneuritis,” Vols. 255(2): 57-65, 1956.
2. B. C. E. H. P. V. D. M. F. G. e. a. JACOBS, “Serum anti‐GQ1b IgG antibodies recognize surface epitopes on Campylobacter jejuni from patients with Miller Fisher syndrome.,” Vols. vol. 37, no 2, p. 260-264, 1995.
3. I. V. A. R. Z. K. D. A. e. a. YEPISHIN, “Miller Fisher syndrome: a case report highlighting heterogeneity of clinical features and focused differential diagnosis.,” Hawai’i Journal of Medicine & Public Health, pp. vol. 75, no 7, 2016.
4. M. K. S. F. T. e. a. MORI, “Clinical features and prognosis of Miller Fisher syndrome,” Neurology, pp. vol. 56, no 8, p. 1104-1106, 2001.
5. L. A. R. V. e. M. N. R. SNYDER, ” The Fisher variant of Guillain-Barré syndrome (Fisher syndrome),” Vols. vol. 29, no 4, p. 312-324., 2009.
6. S. K. Gupta, K. K. Jha, M. D. Chalati and L. T. Alashi, “Case Report: Miller Fisher syndrome,” BMJ Case Reports, 2016.
7. Y. L. LO, ” Clinical and immunological spectrum of the Miller Fisher syndrome,” Muscle & nerve, pp. vol. 36, no 5, p. 615-627., 2007.
8. N. YUKI, ” Molecular mimicry between gangliosides and lipopolysaccharides of Campylobacter jejuni isolated from patients with Guillain-Barré syndrome and Miller Fisher syndrome.,” Vols. vol 176, no Supplement_2, p. S150, 1997.
9. M. K. S. F. T. e. a. MORI, “Intravenous immunoglobulin therapy for Miller Fisher syndrome,” vol. 68, no. no 14, p. 1144-1146., 2007.