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KMID : 1038920180170020033
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Annals of Optometry and Contact Lens
2018 Volume.17 No. 2 p.33 ~ p.38
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Regular Ophthalmic Examination in Miller-Fisher Syndrome Patients
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Kim Bum-Gi
Choi Jin
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Abstract
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Purpose: To investigate the clinical features of Miller-Fisher syndrome patients based on ophthalmologic examination.
Methods: We retrospectively analyzed the medical records of patients diagnosed with Miller-Fisher syndrome at Sanggye Paik hospital from January 2011 to December 2016. We investigated the type of strabismus, angle of deviation, ocular motility disorder, anti-GQ1b antibody positivity, brain magnetic resonance imaging, cerebrospinal fluid examination, accompanying clinical features, and accompanying signs of Miller-Fisher syndrome. We analyzed and compared duration of the disease according to the type of the preceding infection, the presence of pupil involvement and ptosis, the presence of three signs in Miller-Fisher syndrome, and the treatment modalities.
Results: A total of 12 patients were included. Eight men (67%) and four women (33%) were enrolled. Six patients (50%) had symptoms of respiratory infection and four patients (33%) had symptoms of gastrointestinal infection before the onset of ophthalmoplegia. Ophthalmoplegia was lateral rectus muscle palsy in 100 %, medial rectus muscle palsy in 75.0%, superior rectus muscle palsy in 58.3%, and inferior rectus muscle palsy in 50.0% of patients. 100% of patients showed esotropia and 58.3% showed esotropia with vertical strabismus. In three patients (25%), a typical Miller-Fisher syndrome that had all the signs of Miller-Fisher syndrome was present. There was no statistically significant difference in the duration of the disease, depending on the type of the preceding infection, the presence of pupil involvement, the presence of ptosis, the presence of three signs in Miller-Fisher syndrome, and treatment modalities.
Conclusions: Miller-Fisher syndrome is characterized by paralysis of the horizontal extraocular muscles, accompanied by symptoms such as pupil abnormalities and ptosis. There was no effect on the duration of the disease according to the type of preceding infection, the presence of pupil involvement and ptosis, the presence of three signs in Miller-Fisher syndrome, and the treatment modalities.
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KEYWORD
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Miller-Fisher syndrome, Infection, Anti-GQ1b antibody, Ophthalmoplegia, Diagnosis
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