Miller-Fisher syndrome associated with chronic lymphocytic leukemia.
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Chronic lymphocytic leukemia (CLL) is a frequent hematological malignancy, with meningeal or peripheral nerve infiltrations being the most commonly encountered neurological complications. In this report, we describe a CLL patient with Miller-Fisher syndrome (MFS) who responded to immune modulation with plasmapheresis. A 47-year-old man diagnosed as B-cell CLL admitted with neutropenic fever. He complained of diplopia and numbness of both arms. Neurological examination revealed a bilateral external ophthalmoplegia, dysphagia, dysarthria, mild shoulder girdle muscle weakness and gait ataxia, accompanied by absent tendon reflexes. Nerve conduction studies were indicative of a predominantly axonal sensori-motor peripheral neuropathy. This association of CLL with MFS had not been previously reported in the literature. (+info)
Rapid method for sensitive screening of oligosaccharide epitopes in the lipooligosaccharide from Campylobacter jejuni strains isolated from Guillain-Barre syndrome and Miller Fisher syndrome patients.
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Anti-GQ1b-negative Miller Fisher syndrome presented with one-sided horizontal gaze palsy.
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Miller Fisher syndrome classically presents with ophthalmoplegia, ataxia and areflexia. The syndrome may present rarely with atypical clinical features. Whether the central or peripheral nervous system is primarily involved remains controversial. Miller Fisher syndrome usually follows an infection, the most likely being Campylobacter jejuni. Mycoplasma pneumoniae has been reported rarely as the antecedent infectious agent in some patients. Herein, we report a 13-year-old girl with positive mycoplasma immunoglobulin (Ig)M and IgG serology who presented with one-sided horizontal gaze palsy, ataxia, areflexia, and bulbar palsy. Her cranial magnetic resonance imaging was normal and blood serum was negative for anti-GQ1b IgG antibodies. (+info)
Redefining the Guillain-Barre spectrum in children: neuroimaging findings of cranial nerve involvement.
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Fisher syndrome associated with immune thrombocytopenic purpura.
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We describe a 51-year-old man with Fisher syndrome (FS) and immune thrombocytopenic purpura (ITP) that developed after upper respiratory infection (URI). Laboratory investigations demonstrated immunoglobulin (Ig) G class of anti-GQ1b autoantibody and reduced platelet count with platelet-associated IgG, which spontaneously improved in parallel with neurologic symptoms. Thus the possible association of ITP should be considered when encountering a patient with FS. This patient suggests that there may be a certain infectious agent causing URI, leading to the co-occurrence of FS and ITP. (+info)
Recurrent Fisher-Bickerstaff syndrome: report of a Chinese case.
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Fisher-Bickerstaff syndrome (FBS) was recently proposed to help to diagnose the conditions that overlap Fisher syndrome and Bickerstaff's brainstem encephalitis, as well as the unclassified conditions that had ophthalmoplegia and ataxia with clear consciousness, flexor plantar response and preserved tendon reflexes. Recurrences are exceptional with Guillain-Barre syndrome and its variants. Here we reported a patient with diagnosis of recurrent FBS. The patient presented with recurrent drowsiness, unsteady gait, diplopia and reduced deep tendon reflexes, which met the diagnostic criteria for FBS. The interval was eight months. He was treated with intravenous immunoglobulins during each episode and got good recovery. To our knowledge, this is a relatively early report about recurrent FBS case that had central and peripheral involvement during each episode in China. (+info)