Additional Steroid Therapy for Delayed Facial Palsy in Miller Fisher Syndrome

Abstract

Miller Fisher syndrome (MFS) is a variant of Guillain-Barré syndrome. Delayed facial palsy (DFP) is a symptom that occurs after other neurological symptoms begin to recover within four weeks from the onset of MFS. As there have been few detailed reports about DFP in MFS cases treated with additional immunotherapy, we investigated three cases of DFP in MFS treated with additional steroid therapies. The duration of facial palsy in our cases was 12-24 days. No severe adverse effects were observed. Although adverse side effects should be carefully monitored, additional steroid therapy might be a treatment option for MFS-DFP.

A Case with Anti-ganglioside Antibodies Showing Multiple Cranial Nerve Palsies Detected on Gadolinium-enhanced Magnetic Resonance Imaging

“…The efficacy of treatments with intravenous immunoglobulin and plasmapheresis are questioned on MFS, but these treatments might be effective for cases of atypical MFS, such as overlapping GBS ( 3 ). Patients with MFS or GBS sometimes show peripheral facial nerve palsy, which sometimes develop after other symptoms improve ( 7 ). Additional steroid therapies are sometimes effective in treating delayed peripheral facial nerve palsies, as steroid therapy shows efficacy on modulating the immune response or direct reduction of edema ( 7 ).…”

“…Patients with MFS or GBS sometimes show peripheral facial nerve palsy, which sometimes develop after other symptoms improve ( 7 ). Additional steroid therapies are sometimes effective in treating delayed peripheral facial nerve palsies, as steroid therapy shows efficacy on modulating the immune response or direct reduction of edema ( 7 ). The present patient with oculomotor disturbances, peripheral facial nerve palsies, bulbar palsy, and dysesthesia in both palms was first treated with intravenous immunoglobulin.…”