Pamir GÜLEZ, Murat HIZARCIOĞLU, Aycan ÜNALP, Zuhal Önder SİVİŞ

MILLER- FISHER SENDROMU: BİR OLGU SUNUMU

Miller-Fisher sendromu ataksi, oftalmopleji ve arefleksi ile karakterizedir ve Guillain Barre sendromunun bir varyantı olduğu düşünülmektedir. Miller-Fisher sendromu tüm Guillain Barre sendromlu olguların %5-8'ini oluşturur. Ani başlangıçlı eksternal oftalmopleji Miller-Fisher sendromunun kardinal bulgusudur. Miller-Fisher sendromu Guillain Barre sendromundan yalnızca birkaç klinik özellikle ayırt edilebilmekte, laboratuvar bulguları özgün olmadığı için tanı ancak hastalıktan şüphelenildiği durumda konulabilmektedir. Yürüme ataksisi, oftalmopleji ve derin tendon reflekslerinde azalma saptanan beş yaşındaki kız olguda beyin omurilik sıvısında albuminositolojik disosiyasyon, elektromiyografide alt ekstremite distallerinde mikst tip polinöropati bulgularıyla birlikte Miller-Fisher sendromu tanısı konuldu. İntravenöz immunoglobulin 1 g/kg/doz iki gün kullanıldı. Oldukça nadir görülen bir antite olması nedeniyle hatırlatmak amacıyla sunuldu

Anahtar Kelimeler:

Miller-Fisher sendromu, Guillain Barre sendromu, intravenöz immunglobulin

Miller-Fisher Syndrome: A Case Report

Miller-Fisher syndrome is characterized by gait ataxia, external ophtalmoplegia and areflexia and thought as an uncommon variant of Guillain Barre syndrome. Miller-Fisher syndrome is observed in about 5-8% of all Guillain Barre syndrome cases. Acute onset of external ophthalmoplegia is a cardinal feature of Miller-Fisher syndrome. Miller-Fisher syndrome can be distinguished from Guillain Barre syndrome by a few clinical features. Because of the laboratory findings are not spesific for Miller-Fisher syndrome, the diagnosis is made only with suspicion of the disease. Miller-Fisher syndrome was diagnosed at a five years old girl with gait ataxia, ophthalmoplegia, hyporeflexia, cerebrospinal fluid and electromyographic findings. Intravenous immunoglobulin 1g/kg/dose was used for two days. The aim of the case is presented here to remind this very uncommon antity.

Keywords:

Miller-Fisher syndrome, Guillain Barre syndrome, intravenous immunoglobulin,

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Sladky JT, Ashwal S. Inflammatory neuropathies. In: Swaiman KF, Ashwal S, Ferriero DM, editors. Pediatric neurology. Principles and practice. 4th ed. Elsevier, Philadelphia, 2006: 1923.
Bushra JS. Miller-Fisher syndrome: an uncommon acute neuropathy. J Emerg Med 2000;18;427-30.
Van der Meche FG, van Doorn PA, Meulstee J, Jennekens FG. Diagnostic and classification criteria for the Guillain Barre syndrome. Eur Neurol 2001;45:133
Miller Fisher syndrome presented with one-sided horizontal gaze palsy. Turk J Pediatr 2010;52:317-20.
Lo YL. Clinical and immunological spectrum of the Miller Fisher syndrome. Muscle Nerve 2007;36:615
Mori M, Kuwabara S, Fukutake T, Hattori T. Intravenous immunglobulin therapy for Miller-Fisher syndrome. Neurology 2007;68:1144-6.
Ito M, Kuwabara S, Odaka M, et al. Bickerstaff's brainstem encephalitis and Fisher syndrome from a continuous spectrum: clinical analysis of 581 cases. J Neurol 2008;255:674-82.
Sarnat HB. Guillain Barre Syndrome. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. WB Saunders, Philadelphia, 2007: 2565-6. van der Meche FG, van Doorn PA. Guillain Barre YAZIŞMA ADRESİ Uzm. Dr. Pamir GÜLEZ
Dr. Behçet Uz Çocuk Hastanesi İzmir, Türkiye E-Posta: drpgulez@yahoo.com.tr Geliş Tarihi Kabul Tarihi : 24.01.2011