Atypical Miller-Fisher Syndrome Case Which is Start with Swallowing Difficulties

Yıl 2015, Cilt: 16 Sayı: 2, 163 - 166, 15.07.2015

Recep Yevgi , Recep Demir Musa Gümüşdere Gökhan Özdemir Hızır Ulvi

https://doi.org/10.18229/ktd.26166

Öz

Miller-Fisher syndrome (MFS); characterized by ataxia, areflexia, and ophthalmoplegia, was first recognized as a distinct clinical entity in 1956. MFS is considered a variant of Guillain-Barre syndrom(GBS), accounting for 5 to 10% of GBS cases. Ataxia, ophthalmoplegia, areflexia , ptosis, diplopia, mydriasis, facial paralysis, hypoesthesi and rarely quadriparesis can occur in the clinical presentation of the disease. Although MFS is a clinical diagnosis, serological confirmation is possible by identifying the Anti-GQ1b antibody found in most of the affected patients. We prensented an atypical MFS case which is come with swallowing difficulties.

Anahtar Kelimeler

Ataxia, areflexia, ophthalmoplegia, swallowing

Yutma Güçlüğü ile Başlayan Atipik Miller-Fisher Sendromu Olgusu

Öz

Ataksi, arefleksi ve oftalmopleji ile karakterize Miller-Fisher sendromu (MFS), ilk kez 1956 yılında farklı bir klinik antite olarak tanımlandı. MFS, Guillain-Barre Sendromu (GBS)’nun bir varyantı olarak kabul edilir ve GBS olgularının %5-10’nunu oluşturur. Hastalığın klinik seyrinde ataksi, oftalmopleji, arefleksi, pitoz, diplopi, midriyazis, fasial paralizi, hipoestezi ve nadiren kuadriparezi görülebilir. MFS klinik bir tanı olmasına rağmen etkilenen birçok hastada Anti-GQ1b antikorunun pozitif olmasıyla da serolojik olarak doğrulanabilir. Biz bu makalede yutma güçlüğü ile gelen atipik bir MFS olgusu sunduk.

Anahtar Kelimeler

Ataksi, arefleksi, oftalmopleji, yutma

Kaynakça

• Koga M, Yuki N, Hirata K. Subclass distribution and the secretory component of serum IgA anti- ganglioside antibodies in Guillain–Barré syndrome RM, Behrman RE, Jenson HB, Stanton BF. Nelson after Campylobacter jejuni enteritis. J Neuroimmunol textbook of pediatrics. 18th edition. Philadelphia: WB 1999;96(2):245–50.
• Panda S, Tripathi M. Anti-GQ1b antibody syndrome: clinical and immunological range. J Neurol Neurosurg Psychiatry 2002;72(3):418–9.
• Sladky JT, Ashwal S. Inflammatory neuropathies. In: Swaiman KF, Ashwal S, Ferriero DM, editors. Pediatric neurology. Principles and practice. 4th Edition, of Miller Fisher syndrome. Ann Neurol 1992;31(6):677
• Philadelphia: Elsevier, 2006:1923.
• Bushra JS. Miller-Fisher syndrome: an uncommon acute neuropathy. J Emery Med 2000;18(4):427-30. logical evidence of neuromusculartransmission defect in the orbicularis oculi. J Neurol Neurosurg Psychiatry 2004;75(3):436-40.
• Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Serum anti-GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillan Barre syndrome: clinical and immunohistochemical studies. Neurology 1993;43(10):1911-7.
• Vincent A, Palace J, Hilto-Jones D. Myasthenia gravis. Lancet 2001;357(9274): 2122-8.
• Hirch NP. Neuromusculer junction in health and Walter G. Bradley, Robert B. Daroff, Gerald M. Fenichel, C. David Marsden. Neurology in Clinical Practice. 4th Edition, New York: 2000:1338-40.
• Fisher M. An unusual variant of acute idiopathic Li H, Yuan J. Miller-Fisher syndrome: toward a more comprehensive understanding. Chin Med J. A hospital-based retrospective study. Eur Neurol 2000;44(2):79-85.
• Sarnat HB. Guillain Barre Syndrome. In: Kliegman Saunders 2007;2565-6.
• Snyder LA, Rismondo V, Miller NR. The Fisher variant of Guillain-Barre syndrome (Fisher syndrome). J Neuroophtalmol 2009;29(4):312-24.
• Chiba A, Kusunoki S, Shimizu T, Kanazawa I. Serum IgG antibody to gangliozide GQ1b is a possible marker