The Miller Fisher syndrome. Review of the cases of the Santa Maria Hospital.

Abstract

A benign syndrome of acute ophthalmoplegia, ataxia, and areflexia is commonly known as the Miller Fisher syndrome. It is generally believed that Miller Fisher syndrome is a type of Guillain-Barré syndrome, but several authors believe it to be a separate clinical entity caused by a central nervous system lesion. Eight patients with Miller Fisher syndrome diagnosis, admitted to our department in the last 20 years, were reviewed. Neurophysiological studies were carefully reviewed. Our patients had a clinical presentation and evolution identical to that described previously. Neurophysiological abnormalities were found in all patients and were characteristic of a sensory axonal neuropathy, with damage of the facial nerves and occasional demyelination of peripheral nerves. The pattern of abnormalities is distinct from the usual features seen in Guillain-Barré syndrome. The CT scan, MRI, and Evoked Potentials investigations in our patients did not confirm central nervous system lesion. Nevertheless we did not exclude the possibility of coexisting damage to the central nervous system in some patients, as shown in Chronic Inflammatory Demyelinating Polyneuropathy.