Two Cases of Miller Fisher Syndrome without Ataxia

ABSTRACT

A classic triad of acute external ophthalmoplegia, areflexia and ataxia characterizes Miller Fisher syndrome(MFS). Diagnosis is based on clinical findings and supported by two laboratory findings; CSF albuminocytological dissociation and serum anti-GQ1b IgG antibody testing. Anti-GQ1b antibody is a key factor in the pathogenesis of Miller Fisher syndrome and a useful marker in laboratory diagnosis. Here we report 2 cases with Miller Fisher syndrome without ataxia, whose major symptom was acute external ophthalmoplegia. Case 1 was associated with preceding Epstein-Barr virus infection and negative anti- GQ1b antibody. Case 2 was positive for the anti-GQ1b antibody. Both received intravenous immunoglobulin and fully recovered within 2 months after the onset of disease.