Incidentally Developed Miller Fisher Syndrome after Dental Anesthesia -A Case Report-

J Korean Assoc EMG Electrodiagn Med 2009;11(1):51-54.
Published online June 1, 2009.

Abstract

Miller Fisher syndrome (MFS) is characterized by descending paralysis with a classic triad of ataxia, external ophthalmoplegia and areflexia. The authors experienced an incidentally developed MFS after dental anesthesia. A 45-year-old woman had ataxia, diplopia and dysarthria following a dental procedure involving alveolar nerve anesthesia. Lidocaine toxicity had been considered until quadriparesis and respiratory difficulty were developed. Diagnosis of MFS were established and high dose intravenous immunoglobulin therapy with comprehensive rehabilitation care was performed. Since initial symptoms of MFS resemble those of lidocaine toxicity involving ophthalmoplegia, MFS can be misdiagnosed and treatment can be delayed or missed. Further, a dentist can be falsely blamed for the symptoms. Therefore, thorough neurologic examinations and nerve conduction studies are essential in patients who have ophthalmoplegia after dental anesthesia.

Key Words: Miller-Fisher syndrome, Dental anesthesia, Ophthalmoplegia