Miller Fisher Syndrome

Miller Fisher syndrome is a very rare nerve disease that’s related to Guillain-Barré syndrome. Miller Fisher syndrome is a variant of Guillain-Barré syndrome. It’s rarer than Guillain-Barré syndrome.

Causes of Miller Fisher Syndrome

  • Both Miller Fisher syndrome and Guillain-Barré syndrome develop in response to an illness.

  • The illness triggers antibodies to attack your nerves. Experts aren’t sure why this happens.

  • Miller Fisher syndrome usually develops a few days or up to 4 weeks after an illness, especially a diarrheal disease or respiratory infection.

  • Campylobacter jejuni is a common species of bacteria that triggers Miller Fisher syndrome and Guillain-Barré syndrome.

Symptoms of Miller Fisher Syndrome

  • Weakness of your eye muscles, which leads to double vision and difficulty controlling eye movements (ophthalmoplegia)

  • Problems with limb coordination (ataxia)

  • Loss of reflexes in your tendons (areflexia)

Diagnosis of Miller Fisher Syndrome

  • There isn’t a specific diagnostic test for Miller Fisher syndrome.

  • Your doctor will do a physical exam and take a medical history. They may do a spinal tap (lumbar puncture).

  • Many people with Miller Fisher syndrome have a high protein count in their cerebrospinal fluid.

  • Magnetic resonance imaging (MRI) of your brain may be done to rule out brainstem encephalitis and Guillain-Barré syndrome.

  • In Miller Fisher syndrome, an MRI is usually normal, but there may be abnormalities for the other diseases.

  • Your doctor may also carry out a nerve conduction study and electromyography (EMG). These tests use small electric shocks to check the activity of your muscles and sensory nerves.

  • If you have Miller Fisher syndrome, the tests may show abnormalities of your sensory nerves.

Treatment of Miller Fisher Syndrome

  • There’s no cure for Miller Fisher syndrome. But treatment can help your symptoms improve faster.

  • People with Miller Fisher syndrome are usually treated in the hospital.

  • This will allow doctors to rule out Guillain-Barré syndrome, which can be fatal.

  • Because Miller Fisher syndrome is related to Guillain-Barré syndrome, treatments for Guillain-Barré syndrome are usually given.

  • These treatments may include plasma exchange (plasmapheresis) and intravenous immunoglobulin (IVIg).

  • Intravenous immunoglobulin is usually the first treatment given because it’s more widely available and convenient than plasmapheresis.

  • Intravenous immunoglobulin is usually given for 5 days.

  • These infusions contain antibodies found in blood.

  • They come from plasma that’s pooled from thousands of healthy people and then purified.

  • In plasmapheresis, a thin plastic tube connects your vein to a machine. Your blood travels through the tube and into the machine.

  • The machine removes the plasma in your blood and replaces it with substitute plasma.

  • This substitute plasma and your own blood cells are then returned to your body.

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