Algorithm for differential diagnosis of Miller Fisher Syndrome in real clinical practice

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Abstract

Miller Fisher syndrome (MFS), being one of the variants of Guillain – Barre syndrome, refers to acute dysimmune neuropathies with a triad of symptoms in the form of ataxia, ophthalmoplegia and areflexia. The article presents a case of MFS in a 69-year-old female patient, which debuted in a week after the development of pneumonia with rapid arising of complete ophthalmoplegia, ataxia and decreased tendon reflexes. After excluding brainstem stroke, the diagnosis of MFS was made. A high titer of antibodies to gangliosides GT1A, GQ1B was observed in patient’s blood. Plasmapheresis was accompanied by complete regression of ataxia with preservation of ophthalmoplegia. Two months after the start of therapy, antibody titers significantly decreased, and mild ataxic syndrome persisted in the neurological status. Early diagnosis of MFS determines the timely administration of pathogenetic therapy, which contributes to a good outcome of the disease.

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About the authors

Ekaterina S. Ostapchuk

Regional Clinical Hospital No. 1; Tyumen State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: ostapchukes2008@mail.ru
ORCID iD: 0000-0003-1176-4113
SPIN-code: 6877-6140

MD, PhD (Medicine), head of the Department of neurology, associate professor of the Department of neurology with a course in neurosurgery of the Institute of clinical medicine

Russian Federation, Tyumen; Tyumen

Vitaliy V. Kuznetsov

Regional Clinical Hospital No. 1

Email: Vitalij.kuzneczov.1996@mail.ru
ORCID iD: 0009-0003-7721-1682

MD, neurologist at the Department of neurology

Russian Federation, Tyumen

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