Uncommon Features of Miller-Fisher Syndrome. Case Report and review of the literature
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Abstract
Background: Miller Fisher syndrome is an acute autoimmune polyneuropathy characterized by the clinical triad of areflexia, ataxia, and ophthalmoplegia. It is a rare pathology in the pediatric age that is associated, in most cases, with a history of an infectious process. In the cerebrospinal fluid analysis, cytological albumin dissociation and IgG antiganglioside antibodies against GQ1b stand out in more than 80% of cases. Case report: 5-year-old girl with the characteristic clinical triad, acute course, and history of gastrointestinal infection (no known infectious agent). Uncommon findings in the cerebrospinal fluid in this syndrome are described, such as leukocytosis and positivity for IgG antiganglioside antibodies against GT1a. The other antiganglioside antibodies were negative. The complementary tests are not helpful in confirming or ruling out the diagnosis since this is mainly clinical; however, they serve to rule out other pathologies included in the differential diagnosis. Conclusion: an early diagnosis is necessary to establish adequate support measures. Although immunoglobulins and plasmapheresis have been commonly used for their treatment, randomized clinical trials are needed to demonstrate their efficacy.
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