Recurrent Miller Fisher syndrome: clinical and laboratory features

Abstract

To present two patients with Miller Fisher syndrome (MFS) recurrence after 35 and 44 years and review of the literature on recurring MFS. All identified cases with recurrent MFS were evaluated. Age, gender, clinical features of first and recurrent MFS, course of disease, laboratory findings, therapy and outcome were transformed into tables. Twenty-eight patients (16 men, 12 women; mean age at the first episode 34 years (range 13-57 years); mean age at the latest episode 47 years (range 21-66 years) with a total of 70 MFS episodes were identified. Twenty-one patients had a single recurrence, five patients had two recurrences, one patient had four recurrences and one patient had seven recurrences. The mean interval between attacks was 9.45 years (3 months to 44 years). In 76% of the initial episodes and in 81% of the recurrent episodes, an infectious disease preceded MFS. Additional facial and bulbar symptoms and autonomic disturbances were frequent findings. Cerebrospinal fluid (CSF) and electrodiagnostic findings were unspecific. If tested, autoantibodies against GQ1b had been positive in all episodes. In about half of the patients, immunotherapy was applied. The outcome was favourable in most patients. Recurrence of MFS is a rare quite uniform condition with a mostly favourable prognosis.

Síndrome anti-GQ1b: Descripción de cuatro pacientes y revisión de la literatura

“…Aunque la mayoría son condiciones agudas y autolimitadas, existen varios reportes de recurrencia asociada a la presencia de anti-GQ1b ya sea en el SMF, EB o OA, incluso recurriendo hasta en siete ocasiones, pero siempre con evolución favorable [13][14][15] .…”

Cerebrospinal Fluid in Clinical Neurology

“…Pleocytosis was present only in two cases. Repeated CSF examination in two cases indicated a slight increase in the protein content (Heckmann and Dütsch 2012 ).…”

Acute and chronic ataxic neuropathies with disialosyl antibodies: A continuous clinical spectrum and a common pathophysiological mechanism

“…FS rarely recurs. In a recent review of 28 patients, a total of 70 episodes were identified . An infectious disease preceded FS in 76% of the initial episodes and in 81% of recurrent episodes.…”