Miller Fisher-Syndrome with faryngeal-brachial-cervical and facial weakness: A case report

Abstract

Miller Fisher Syndrome (MFS) , a variant form of Guillian -Barre Syndrome (GBS) ischaracterized by the triad of opthalmoplegia, ataxia, reduced and absent tendon reflexes with no or minimal limb weakness. Oropharyngeal, neck and proximal upper limb muscles weakness may be involved, like in another GBS variant, the pharyngeal-brachial-cervical (PBC) variant. Opthalmoplegia and ataxia have been also reported in the PBC variant.Although some clinical and immunological differences have been proposed, its unclear whether these are distinct clinical entities or overlapping clusters within the spectrum of clinically defined GBS. In this study, the clinical, electrophysiological findings and follow-up data of a patient fulfilling the clinical criteria of MFS were presented. She had also weakness of the oropharynx, neck and proximal upper limb muscle. We maintained the name MFS for this patient by using it in a wider context MFS and PBC variants were discussed on clinical and electrophysiological grounds by reviewing the recent literature.