A Case of Miller Fisher Syndrome Showing Axonal Polyneuropathy in Electrodiagnostic Test

J Korean Assoc EMG Electrodiagn Med 2004;6(1):67-70.
Published online May 10, 2004.

Abstract

Miller Fisher syndrome is clinically characterized by the triad of gait ataxia, external ophthalmoplegia and areflexia. A six-year-old girl developed ophthalmoplegia and mydriasis after a febrile flu-like illness. She had additional symptoms of dysphgia and dysarthria in 4 days after the onset. The symptoms were progressively aggravated to total ophthalmoplegia, facial diplegia, bulbar palsy, ataxia, areflexia and weakness of extremities. She was unable to maintain an upright posture, nor able to walk because of severe trunkal ataxia and weakness of extremities. The cerebrospinal fluid showed mild albumino-cytologic dissociation and electrodiagnostic study revealed a predominantly motor axonal peripheral polyneuropathy including both facial nerves. She was placed on a high dose of intravenous immunoglobulin and comprehensive rehabilitation treatment which resulted in a complete recovery in 6 months. This is a case of Miller Fisher syndrome which presented atypically severe weakness of extremities in clinically and generalized motor axonal polyneuropathy in electrodiagnostically.

Key Words: Miller Fisher syndrome, Total ophthalmoplegia, Axonal neuropathy