Miller-Fisher syndrome and Hodgkin's disease

Lymphoma-associated dysimmune polyneuropathies

“…An elevated serum anti-GQ1b antibody titer is deemed useful supportive evidence for (? postinfectious) MFS [110,111], but was recorded in only 1 of 4 lymphoma patients [106]. CSF analysis on 3 patients showed only elevated protein concentration [106,107,109]; however, "atypical", non-neoplastic lymphocytes were detected on repeat CSF evaluation in the patient with recurrent MFS [109].…”

“…The temporal association between a diagnosis of MFS and lymphoma varied: (a) onset of MFS coincided with the 2nd relapse of lymphoma [106]; (b) MFS coincided with the discovery of lymphoma in a renal transplant recipient on anti-rejection therapy [107]; (c) MFS developed in a patient with CLL during chemotherapy [108], and (d) a detailed evaluation during recurrence of MFS detected lymphoma [109]. An elevated serum anti-GQ1b antibody titer is deemed useful supportive evidence for (?…”

“…postinfectious) MFS [110,111], but was recorded in only 1 of 4 lymphoma patients [106]. CSF analysis on 3 patients showed only elevated protein concentration [106,107,109]; however, "atypical", non-neoplastic lymphocytes were detected on repeat CSF evaluation in the patient with recurrent MFS [109]. Electrodiagnostic studies were variably interpreted as: (a) axonal sensory polyneuropathy [106]; (b) diffuse, predominantly axonal sensorimotor polyneuropathy [107,108], or (c) sensorimotor demyelinating polyradiculoneuropathy [109].…”

“…Three patients showed neurological response to treatment [106,108,109]; 1 treatment-unresponsive patient showed neurological improvement to systemic chemotherapy for lymphoma [107]. The patient with recurrent MFS and CSF atypical pleocytosis showed neurological improvement to a combined systemic/intrathecal chemotherapy regimen [109]; neurological response to systemic chemotherapy was interpreted as evidence of a "paraneoplastic" pathogenesis (herein defined as the production of a specific antibody against an antigen of malignant cells that crossreacts with an antigen of normal neurological tissue).…”

Anti-GQ1b-negative Miller–Fisher syndrome with lower cranial nerve involvement from parasinusoidal aspergilloma

“…23 Recently, MFS associated with lung cancer 24 or Hodgkin's lymphoma was reported. 25 In rare cases the association of MFS with rheumatological disease and adult-onset Still's disease has been reported. 26 Sialo-acid-containing lipo-polysaccharides are thought to trigger MFS through molecular mimicry with gangliosides in peripheral nerves.…”