MILER FISEROV SINDROM
Abstract
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.
References
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