Síndrome de Miller Fisher. A propósito de un caso / Miller Fisher syndrome. A case report

El síndrome de Miller Fisher es una variedad clínica del síndrome de Guillain-Barré, que se caracteriza por oftalmoplejía, arreflexia y ataxia. Se presenta el caso de una paciente de 6 años de edad, atendida en el Hospital Pediátrico Docente Pepe Portilla de Pinar del Río, en noviembre de 2010; con antecedentes de salud anterior, que 5 días previos al inicio del cuadro tuvo una infección respiratoria alta aguda, seguida de un cuadro de debilidad bucofaríngea y facial, ataxia y debilidad muscular intensa de las extremidades. Se interconsulta con el servicio de Neurología, donde se constata diplejía facial periférica, parálisis del IV par izquierdo, ataxia e hiporreflexia; se le realizan varias investigaciones e ingresa en la Unidad de Cuidados Intensivos con el diagnóstico de síndrome de Miller Fisher. Se comienza el tratamiento con terapéuticocon, intacglobin y vitaminoterapia, logrando una evolución satisfactoria de la paciente a los 10 días de su ingreso en el servicio de UCI con regresión del cuadro.

Miller Fisher syndrome is a clinical variant of Guillain-Barré syndrome it is characterized by ophthalmoplegia, areflexia and ataxia. A six-year old female patient attended to "Pepe Portilla" Children Hospital, Pinar del Rio in November 2010; with past health records, who 5 days before the onset of the disorder suffered from an acute upper respiratory infection that was followed by a picture of buccopharyngeal and facial weakness, ataxia and acute muscular debility of the limbs. A referral to Neurology service verified peripheral facial diplegia, paralysis of the IV left pair, ataxia and hyporeflexia; several examinations were performed before admitting her to the Intensive Care Unit (ICU) with the diagnosis of Miller Fisher syndrome. The therapeutic treatment included intacglobin and vitamins, achieving a satisfactory progress; the patient was discharged from the ICU 10 days after her admission with a total regression of the clinical picture.

Guillain-Barre syndromes accompanied by optic neuritis

Although Guillain Barre sydrome(GBS) is known to be a demylinating disease of the peripheral nervous system, it has been rarely repored that GBS was accompanied by demyelinating disease of the central nervous system such as multiple sclerosis, optic neuritis or acute disseminated encephalomyelitis. We experienced a patients with GBS who developed unilateral opticneuritis. A 19-year-old male patient was presented with ascending weakness. A few days later, he complained of decreased visual acuity and pain on the right eye. Cerebrospinal fluid findings were compatible with GBS and serial visual evoked potential studies were indicative of optic neuritis. This case suggests common pathogenesis between central and peripheral demyelinating diseases.