MILER FISEROV SINDROM

  • ana d azanjac Univerzitet u Kragujevcu Medicinski fakultet Kragujevac

Sažetak


Miller- Fisher sindrom (MFS) јe akutna demijelinizaciona polineuropatija koja se karakteriše oftalmoplegijom, ataksijom i arefleksijom. Predstavlja varijantu  Guillain Barre-ovog sindroma. МFS je retko neurološko oboljenje, čini 5%  pacijenata sa GBS.

U našem radu prikazali smo dvadesetčetvorogodišnjeg pacijenta muškog pola čiju kliničku sliku karakteriše: oftalmoplegija, diplegija facijalnog nerva, bulbarba pareza, arefleksija i ataksija. Lumbalnom punkcijom je utvrđena albuminocitološka disocijacija. Pacijent je lečen imunomodulatornom terapijom u vidu intravenskih imunoglobulina, a nakon toga dugotrajnom fizikalnom terapijom. Nakon godinu dana od pojave prvih simptoma došlo je do potpunog oporavka pacijenta.

 

Ključne reči: Miller-Fisher sindrom, oftalmoplegija, ataksija, arefleksija.

Biografija autora

ana d azanjac, Univerzitet u Kragujevcu Medicinski fakultet Kragujevac

doktor medicine

saradnik u nastavi na Katedri za neurologiju

Reference

S.Pulitano et al: Miller-Fisher syndrome mimicking intracranial hypertension following head trauma. Childs Nerv.Syst (2005) 21: 473-476.

Landry O: Note sur la parealysie ascedante aigue. Gazette Hebdomadaire de Medicin 1859; 6: 472-474. 486-488.

Guillain G, Baree JA, Strohl A. Sur un syndrome de radiculo-nevrite hyperalbuminose du liquide cephalorachidien sans reaction cellulaire. Bull Soc Med Hop Paris 1916; 40: 1462-1470.

Collier J. Peripheral neuritis. Edinburgh Med J 1932; 39: 601-618.

Fisher M. An unusual variant of acute idiopatic polyneuritis (syndrome of ophtalmoplegia, ataxia and areflexia) N Engl J Med 1956; 255: 57-65.

McGrogan A, Madle GC, Seaman HE, de Vries CS. The epidemiology of Guillain-Barre syndrome worldwide. A systematic literature review. Neuroepidemiol 2009; 32: 150-163.

Emilia-Romagna Study Group on Clinical and Epidemiological Problems in neurology. Guillain Barre syndrome variants in Emilia-Romagna, Italy, 1992-3: incidence, clinical features, and prognosis. J. Neurol Neurosurg Psychiatry 1998; 65: 218-224.

Z.Aranyi, T.Kovasc, I, Sipos and D.Bereczki: Miller Fisher syndrome: brief overview and update with a focus on electrophysiological findings. European Journal of Neurology 2012, 19: 15-20.

Josef Finsterer et al: Anti-GQ1b-negaitve Miller Fisher syndrome with lower cranial nerve involvement from parasinusoidal aspergilloma. Journal of Infection (2006) 52, e81-e85.

J B Winer: Bickerstaff s encephalitis and Miller Fisher syndrome. J Neurol Neurosurg Psychiatry 2001; 71: 433-435.

Y.Nishimoto, M. Odaka, K. Hirata, N. Yuki: Usefulness of anti-GQ1b antibody testing in Fisher syndrome compared with cerebrospinal fluid examination. Journal of Neuroimmunology 2004; 148: 200-205.

Wessig C, Buchwald B, Toyka KV, Martini R. Miller Fisher syndrome: immunofluorescence and immunoelectron microscopic localization of IgG at the mouse neuromuscular junction. Acta Neuropathol 2001; 101: 239-244.

Gouranga Santra, AK Datta: Miller Fisher Syndrome-An Uncommon Clinical Presentation. J Assoc Physicians India. 2008 Nov; 56: 898-900.

Mori M et al.: Clinical features and prognosis of Miller Fisher Syndrome. Neurology 2001; 56: 1104-1106.

Ito M, Kuwabara S, Odaka M, et al. Bickerstaffs brainstem encephalitis and Fisher syndrome form a continuous spectrum: clinical analysis of 581 cases. J. Neurol 2008; 255: 674-682.

Jamal GA, Ballantyne JP. The localization of the lesion in patients with acute ophthalmoplegia, ataxia and areflexia (Miller Fisher syndrome). A serial multimodal neurophyological study. Brain 1988; 111: 95-114

Fross RD, Daube JR. Neuropathy in Miller Fisher syndrome: clinical and electrophysiologic findings. Neurology 1987; 37: 1493-1498

Ogawara K, Kuwabara S, Yuki N. Fisher syndrome or Bickerstaffs brainstem encephalitis? Anti-GQ1b anti body syndrome involving both the peripheral and the central nervous systems. Muscle Nerve 2002; 26: 845-849

Overell JR, Hsieh ST, Odaka M, Yuki N, Willison HJ. Treatment for Fisher syndrome, Bickerstaff's brainstem encephalitis and related disorders. Cochrane Database Syst Rev 2007; (1): CD004761

Mori M, Kuwabara S, Fukutake T, Hattori T. Intravenous immunoglobulin therapy for Miller-Fisher syndrome. Neurology 2007;68(14):1144–1146

Objavljeno
2013/09/30
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