The Fisher variant of Guillain-Barré syndrome (Fisher syndrome).

Fisher syndrome (FS) is an acute polyneuropathy typically characterized by the triad of ataxia, areflexia, and ophthalmoplegia, although it may present with 2 or even just 1 of these clinical findings. Similarities between FS and other acute polyneuropathies such as Guillain-Barré syndrome (GBS) and Bickerstaff brainstem encephalitis (BBE) suggest that FS is part of a spectrum of autoimmune disorders that may affect the peripheral and/or central nervous system. Anti-GQ1b antibody is present in the serum of more than 85% of patients with FS, but it is not specific to FS. Why some patients develop FS and others develop typical GBS or one of its other variants is still largely unknown.

Herpes zoster vasculitis presenting as giant cell arteritis with bilateral internuclear ophthalmoplegia.

PURPOSE: To present a case of herpes zoster vasculitis presenting as giant cell arteritis. DESIGN: Interventional case report. METHODS: A 77-year-old woman presented with sudden onset of diplopia associated with temple headaches and a previous history of herpes zoster ophthalmicus. A temporal artery biopsy was obtained and in-situ hybridization performed for herpes zoster DNA. RESULTS: The patient presented with a bilateral internuclear ophthalmoplegia. Initial diagnostic evaluation, including erythrocyte sedimentation rate, C-reactive protein, and temporal artery biopsy, was consistent with giant cell arteritis. However, in-situ hybridization of the temporal artery specimen was positive for herpes zoster DNA. CONCLUSIONS: Herpes zoster vasculitis may mimic giant cell arteritis and should be considered in the differential of any patient with presumed giant cell arteritis with suspicious findings, central nervous system involvement, or previous herpes zoster infection.

Reversible cortical blindness in preeclampsia.

PURPOSE: To report the clinical course and magnetic resonance imaging (MRI) findings in a 28-year-old woman with preeclampsia and reversible cortical blindness. DESIGN: Interventional case report. METHODS: The patient presented at the 37th week of pregnancy with headache and hypertension. The next day, her visual acuity decreased to light perception in both eyes. After emergent cesarean section, examination revealed reactive pupils and normal fundi. RESULTS: Magnetic resonance imaging of the brain showed areas of increased signal in both occipital lobes. One month later, at which time the patient's visual acuity had returned to 20/20, follow-up MRI showed complete resolution of radiologic abnormalities. CONCLUSIONS: Cortical blindness is a rare complication of preeclampsia. In this case, cortical blindness was reversible and most likely due to vasogenic edema rather than vasospasm.