|Title||A CASE OF MILLER-FISHER SYNDROME: A VARIANT OF GUILLAIN-BARRE SYNDROME|
|Author, Co-Author||Mayra Rullan, Vassilios Boulougouris|
Southern Hem I,II
|Abstract|| PURPOSE. Guillain-Barre syndrome(GBS) is considered an inflammatory polyneuropathy characterized by the loss of motor function and areflexia. The onset is acute and a viral prodrome usually precedes the disease. The condition is symmetrical and progressive and although its etiology is still questionable, it is believed to be due to an auto immune process. The most common variant of GBS is called "Miller-Fisher syndrome" (IFS) and is typically characterized by the triad of acute ophthalmoplegia, ataxia and areflexia. Diagnosis is based on history, clinical examination, laboratory testing which includes CSF analysis, and CT-scan or Magnetic resonance(MRI) in order to rule out intracranial disease. METHOD. The authors present a case of a 17 year old male who presented with the complaint of double vision of two days onset accompanied by dizziness, vomiting and weakness. The patient had a two week history of flu- like symptoms. Ocular examination revealed a mild left VII nerve palsy with partial right III nerve and VI nerve palsy.
RESULTS. The patient was referred for neurological consultation which initially did not indicate anything specific including a negative CT-scan. Within one week the patient symptomatology worsened and hospitalization was immediately ordered. During this period a second neurological evaluation was performed revealing a mixed ophthalmoplegia, ataxia, areflexia and a VII nerve palsy. MRI was negative and CSF lab results showed protein of 80 mg/dl and zero cells. A diagnosis of Miller-Fisher syndrome was made. CONCLUSION. This case discusses the symptomatology and signs in patients presenting with inflammatory polyneuropathy. It emphasizes the role of optometrists as primary care providers in ruling out neurological disease with prompt, appropriate referrals and follow-up evaluations.
|Affiliation of Co-Authors|