Miller Fisher Syndrome: A Case Report Which can be Confused with Bickerstaff Encephalitis

Abstract

Background: Guillain Barre syndrome with ohtalmoplegia, Miller-Fisher syndrome and Bickerstaff encephalitis are diseases that have a common background. Objective: We aimed to evaluate the clinical, laboratory and radiological findings, differential diagnosis and treatm ent options of Miller Fisher syndrome, a rarely seen variant of Guillan-Barre, and Bickerstaff encephalitis. Findings: 56 year old female patient was admitted to the hospital with cephalgy, stupor and diplopia, which have started 4 days after a viral infection. in her neurological examination, stupor; bilateral horizontal and upward gaze deficiency when awake; loss of deep tendon reflexes, loss of position and vibration sense and ataxia were detected. At the first day of her hospitaliza tion albuminocytological dissociation was present in her CSF. No pathological findings were present in her computed tomography and magnetic resonance imaging. Electroneuromyographic findings were in normal limits. The patient hospitalized with pre-diagnosis of Miller Fisher syndrome and Bickerstaff encephalitis and was diagnosed definetely as having Miller-Fisher syndrome according to her clinical, laboratory and radiological findings and took a 5 day IVIG therapy (400mg/kg/per day). Following therapy, improvement in her clinical findings was observed. Conclusion: In our article; clinical, laboratory, radiological findings and treatment options of the patient with signs of ophthalmoplegia, ataxia and areflexia are introduced along with literature.