Atypical Miller-Fisher Syndrome Case Which is Start with Swallowing Difficulties

Öz

Miller-Fisher syndrome (MFS); characterized by ataxia, areflexia, and ophthalmoplegia, was first recognized as a distinct clinical entity in 1956. MFS is considered a variant of Guillain-Barre syndrom(GBS), accounting for 5 to 10% of GBS cases. Ataxia, ophthalmoplegia, areflexia , ptosis, diplopia, mydriasis, facial paralysis, hypoesthesi and rarely quadriparesis can occur in the clinical presentation of the disease. Although MFS is a clinical diagnosis, serological confirmation is possible by identifying the Anti-GQ1b antibody found in most of the affected patients. We prensented an atypical MFS case which is come with swallowing difficulties.

Anahtar Kelimeler

• Ataxia
• areflexia
• ophthalmoplegia
• swallowing

Yutma Güçlüğü ile Başlayan Atipik Miller-Fisher Sendromu Olgusu

Öz

Ataksi, arefleksi ve oftalmopleji ile karakterize Miller-Fisher sendromu (MFS), ilk kez 1956 yılında farklı bir klinik antite olarak tanımlandı. MFS, Guillain-Barre Sendromu (GBS)’nun bir varyantı olarak kabul edilir ve GBS olgularının %5-10’nunu oluşturur. Hastalığın klinik seyrinde ataksi, oftalmopleji, arefleksi, pitoz, diplopi, midriyazis, fasial paralizi, hipoestezi ve nadiren kuadriparezi görülebilir. MFS klinik bir tanı olmasına rağmen etkilenen birçok hastada Anti-GQ1b antikorunun pozitif olmasıyla da serolojik olarak doğrulanabilir. Biz bu makalede yutma güçlüğü ile gelen atipik bir MFS olgusu sunduk.

Anahtar Kelimeler

• Ataksi
• arefleksi
• oftalmopleji
• yutma

Kaynakça

1. Koga M, Yuki N, Hirata K. Subclass distribution and the secretory component of serum IgA anti- ganglioside antibodies in Guillain–Barré syndrome RM, Behrman RE, Jenson HB, Stanton BF. Nelson after Campylobacter jejuni enteritis. J Neuroimmunol textbook of pediatrics. 18th edition. Philadelphia: WB 1999;96(2):245–50.
2. Panda S, Tripathi M. Anti-GQ1b antibody syndrome: clinical and immunological range. J Neurol Neurosurg Psychiatry 2002;72(3):418–9.
3. Sladky JT, Ashwal S. Inflammatory neuropathies. In: Swaiman KF, Ashwal S, Ferriero DM, editors. Pediatric neurology. Principles and practice. 4th Edition, of Miller Fisher syndrome. Ann Neurol 1992;31(6):677
4. Philadelphia: Elsevier, 2006:1923.
5. Bushra JS. Miller-Fisher syndrome: an uncommon acute neuropathy. J Emery Med 2000;18(4):427-30. logical evidence of neuromusculartransmission defect in the orbicularis oculi. J Neurol Neurosurg Psychiatry 2004;75(3):436-40.
6. Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Serum anti-GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillan Barre syndrome: clinical and immunohistochemical studies. Neurology 1993;43(10):1911-7.
7. Vincent A, Palace J, Hilto-Jones D. Myasthenia gravis. Lancet 2001;357(9274): 2122-8.
8. Hirch NP. Neuromusculer junction in health and Walter G. Bradley, Robert B. Daroff, Gerald M. Fenichel, C. David Marsden. Neurology in Clinical Practice. 4th Edition, New York: 2000:1338-40.

9. Fisher M. An unusual variant of acute idiopathic Li H, Yuan J. Miller-Fisher syndrome: toward a more comprehensive understanding. Chin Med J. A hospital-based retrospective study. Eur Neurol 2000;44(2):79-85.
10. Sarnat HB. Guillain Barre Syndrome. In: Kliegman Saunders 2007;2565-6.
11. Snyder LA, Rismondo V, Miller NR. The Fisher variant of Guillain-Barre syndrome (Fisher syndrome). J Neuroophtalmol 2009;29(4):312-24.
12. Chiba A, Kusunoki S, Shimizu T, Kanazawa I. Serum IgG antibody to gangliozide GQ1b is a possible marker