Motor and sensory conduction failure in overlap of Guillain–Barré and Miller Fisher syndrome: Two simultaneous cases

Non-demyelinating, reversible conduction failure in a case of pharyngeal–cervical–brachial weakness overlapped by Fisher syndrome

“…NCS findings in PCB and FS patients have been variably reported, suggesting demyelinating or axonal neuropathies [19][20][21]. Recent reports where serial NCS were performed have shown patterns suggesting axonal conduction failure [19,20]. Together with these reports, our case suggests that PCB, FS and PCB/FS fall in a continuous spectrum with axonal GBS subtypes.…”

“…One reported poor persistence of median and peroneal F-responses, and bilateral delayed second component of the blink reflex, while the other had mild reduction in sensory amplitudes [2,14]. NCS findings in PCB and FS patients have been variably reported, suggesting demyelinating or axonal neuropathies [19][20][21]. Recent reports where serial NCS were performed have shown patterns suggesting axonal conduction failure [19,20].…”

Serial nerve conduction studies provide insight into the pathophysiology of Guillain–Barré and Fisher syndromes

“…The other four patients were noted to have absent F waves but otherwise no other demyelinating features to suggest AIDP. More recently, Rajabally et al [9] reported a similar pattern of reversible motor and sensory conduction failure in two patients. However, the repeated neurophysiology studies in their patients were performed almost three months apart making it difficult to further comment on the rate of recovery of the electrophysiological abnormalities.…”

“…The neurophysiology from previous reports of FS/GBS overlap cases also support an axonal pattern of neuropathy, suggesting that FS overlaps specifically with AMAN [8,9,22,23]. At the time, Katsuno et al [22] as well as Uncini and Lugaresi [23] referred to this group of patients as FS with tetraparesis.…”

“…Reports of patients with FS overlapped by GBS (FS/GBS overlap) have also facilitated in the better understanding of FS [8,9]. It is increasingly recognized that serial nerve conduction studies (NCS) have played an important role in our improved understanding of GBS.…”