A Case of Atypical Miller-Fisher Syndrome with Internal Carotid Artery Stenosis.

Jin,  Ji Hoon; Choi,  Eun Hye; Cho,  Sung Dae; Son,  Byong Kwan; Kang,  Sung Mo; Kwon,  Young Se

Case Report

Journal of the Korean Child Neurology Society 2010;18(2):311-316.
Published online November 30, 2010.

A Case of Atypical Miller-Fisher Syndrome with Internal Carotid Artery Stenosis.

Ji Hoon Jin, Eun Hye Choi, Sung Dae Cho, Byong Kwan Son, Sung Mo Kang, Young Se Kwon

¹Department of Pediatrics, College of Medicine, Inha University, Korea. ysped@inha.ac.kr
²Department of Ophthalmology, College of Medicine, Inha University, Korea.

Abstract

Miller-Fisher syndrome is an acute poly-neuropathy typically characterized by the triad of ophthalmoplegia, ataxia, and areflexia. Other poly-neuropathy diseases include Guillain-Barre syndrome and Bickerstaff brainstem encephalitis. However, not all cases of Miller-Fisher syndrome have the typical three symptoms. These diseases have been differentiated by clinical manifestations and anti-GQ1b IgG antibody testing. In Miller-Fisher syndrome, anti-GQ1b IgG antibody is present in over 95% of patients; however, the frequency is not so high in normal subjects or in those with other poly-neuropathy diseases. Infectious illnesses, such as respiratory diseases and gastrointestinal diseases, usually precede Miller-Fisher syndrome. In general, Miller-Fisher syndrome is a self-limiting illness; however, a few cases of Miller-Fisher syndrome progressing to respiratory failure have been reported, particularly in children. In this case, we report abnormal angiographic findings. We report a case of atypical Miller-Fisher syndrome with internal carotid artery stenosis treated with prednisolone.

Key Words: Miller Fisher Syndrome, Polyneuropathies, Child, Vascular stenosis