Miller-Fisher Syndrome: Is the ataxia central or peripheral?

Cerebellum & Ataxias
Robert D SandlerMarios Hadjivassiliou

Abstract

A 50-year-old man presented with a brief history of slurred speech, unsteadiness, double vision and paraesthesia. He had been unwell for 12 days with campylobacter gastroenteritis. On examination, there was ophthalmoplegia, nystagmus, areflexia and lower limb and gait ataxia. Serological testing was positive for GQ1b antibody in keeping with the diagnosis of Miller Fisher Syndrome (MFS). He was treated with two courses of intravenous immunoglobulins and made a good recovery, only displaying mild gait ataxia when reviewed in clinic 2.5 months later. There has long been a debate as to whether the ataxia in MFS originates in the cerebellum or it is more peripheral. In this case, magnetic resonance spectroscopy (MRS) revealed a reduced NAA/Cr ratio in the cerebellar vermis and right cerebral hemisphere, suggestive of cerebellar dysfunction. The NAA/Cr normalised 2.5 months later reflecting the clinical recovery. The findings on MRS suggest that the cerebellum is involved in MFS.

References

Mar 29, 2001·Journal of Magnetic Resonance Imaging : JMRI·S M BoeschS Felber
Jul 26, 2002·Clinical Neurology and Neurosurgery·F Irsel TezerOkay Saribas
Feb 19, 2005·Neurobiology of Aging·A J RossH Brodaty
Jul 22, 2008·BMJ : British Medical Journal·John B Winer
Dec 11, 2008·Journal of Neurology, Neurosurgery, and Psychiatry·Y K KimS-H Park
Apr 3, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jong Seok BaeOeung Kyu Kim
Nov 11, 2011·Acta Neurologica Scandinavica·M HadjivassiliouI D Wilkinson
Apr 14, 2012·Muscle & Nerve·Maggie W Waung, Mike A Singer
Sep 20, 2012·Internal Medicine·Makoto HaraSusumu Kusunoki
Dec 1, 2012·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·D AjenaG Squintani
Feb 26, 2013·Journal of Neuroradiology. Journal De Neuroradiologie·Marius HadjivassiliouNigel Hoggard

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Citations

Jun 12, 2020·The Cerebellum·M HadjivassiliouN Hoggard

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