Optic Neuritis in a Patient with Miller-Fisher Syndrome†
Praween Lolekha MD*, Kammant Phanthumchinda MD*
Affiliation : † This manuscript was presented at 7th ASEAN Neurological Association (ASNA) Convention & 47th Annual Meeting of the Neurological Society of Thailand, March 2007 * Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok
Miller-Fisher syndrome (MFS) is considered a variant of Guillain-Barré syndrome (GBS). The syn- drome is characterized by acute onset of gait ataxia, ophthalmoplegia, and areflexia. Conventionally, MFS has been considered exclusively a disease of the peripheral nervous system. However, there are occasional reports of central nervous system involvement. Here, a 62 year-old woman who presented with classical features of MFS and progressive bilateral dyschromatopsia and reported visual impairment. Normal MRI of the brain and CSF albumino-cytologic dissociation were observed. CSF oligoclonal IgG pattern indicated a passive transfer of oligoclonal IgG from a systemic inflammatory response. Nerve conduction studies showed slow motor conduction velocity in her extremities. The optic fundi were normal. Visual evoked potentials (VEPs) revealed bilateral optic neuropathy. Marked spontaneous improvement of her syndrome was docu- mented within six weeks. Optic neuritis may be a central nervous system feature that should be recognized as part of the MFS.
Keywords : Miller-Fisher syndrome, Optic neuritis
