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

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...

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Autores principales: Sandler, Robert D, Hoggard, Nigel, Hadjivassiliou, Marios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552373/
https://www.ncbi.nlm.nih.gov/pubmed/26331046
http://dx.doi.org/10.1186/s40673-015-0021-3
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author Sandler, Robert D
Hoggard, Nigel
Hadjivassiliou, Marios
author_facet Sandler, Robert D
Hoggard, Nigel
Hadjivassiliou, Marios
author_sort Sandler, Robert D
collection PubMed
description 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.
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spelling pubmed-45523732015-09-01 Miller-Fisher Syndrome: Is the ataxia central or peripheral? Sandler, Robert D Hoggard, Nigel Hadjivassiliou, Marios Cerebellum Ataxias Commentary 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. BioMed Central 2015-03-01 /pmc/articles/PMC4552373/ /pubmed/26331046 http://dx.doi.org/10.1186/s40673-015-0021-3 Text en © Sandler et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Commentary
Sandler, Robert D
Hoggard, Nigel
Hadjivassiliou, Marios
Miller-Fisher Syndrome: Is the ataxia central or peripheral?
title Miller-Fisher Syndrome: Is the ataxia central or peripheral?
title_full Miller-Fisher Syndrome: Is the ataxia central or peripheral?
title_fullStr Miller-Fisher Syndrome: Is the ataxia central or peripheral?
title_full_unstemmed Miller-Fisher Syndrome: Is the ataxia central or peripheral?
title_short Miller-Fisher Syndrome: Is the ataxia central or peripheral?
title_sort miller-fisher syndrome: is the ataxia central or peripheral?
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552373/
https://www.ncbi.nlm.nih.gov/pubmed/26331046
http://dx.doi.org/10.1186/s40673-015-0021-3
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