Posterior Reversible Encephalopathy Complicating Intravenous Immunoglobulins in a Patient with Miller-Fisher Syndrome

2005 ◽  
Vol 54 (1) ◽  
pp. 58-60 ◽  
Author(s):  
Masashi Nakajima
Keyword(s):  
Intravenous Immunoglobulins ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome following Miller-Fisher syndrome

2021 ◽  
Vol 14 (7) ◽  
pp. e242231
Author(s):  
Catarina Bernardes ◽  
Cristiana Silva ◽  
Gustavo Santo ◽  
Inês Correia
Keyword(s):  
Intravenous Immunoglobulin ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Brain Mri ◽  
Clonic Seizure ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Fluid Analysis ◽  
Immunoglobulin Treatment ◽  
Reversible Encephalopathy

A 71-year-old woman presented to the emergency room with dysphonia, diplopia, dysphagia and generalised weakness since that day. Neurological examination revealed eye adduction limitation, ptosis, hypoactive reflexes and gait ataxia. Blood and cerebrospinal fluid analysis and brain CT were normal. Electromyography revealed a sensory axonal polyneuropathy. She was diagnosed with Miller-Fisher syndrome (MFS) and started on intravenous immunoglobulin. Two days after intravenous immunoglobulin treatment was completed, she developed a sustained hypertensive profile and presented a generalised tonic-clonic seizure. Brain MRI was suggestive of posterior reversible encephalopathy syndrome (PRES) and supportive treatment was implemented with progressive improvement. PRES may be a possible complication of MFS not only due to autonomic and inflammatory dysfunctions, but also as a consequence of its treatment. Patients with MFS should be maintained under close surveillance, especially in the first days and preferably in intermediate care units.

CNS RELAPSE OF NHL MASQUERADING AS MILLER FISHER SYNDROME

2015 ◽  
Vol 86 (11) ◽  
pp. e4.62-e4
Author(s):  
Sonali Dharia ◽  
Timothy Harrower
Keyword(s):  
Nk Cell ◽  
Cranial Nerves ◽  
Previous History ◽  
Intravenous Immunoglobulins ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Cns Relapse ◽  
History Of

A 60 year old man with previous history of NHL (Non Hodgkin Lymphoma) presented with progressive dysphagia and dysarthria over two weeks.He had bilateral lower motor neuron facial weakness, diplopia on lateral gaze and nystagmus on examination. Working diagnosis was Miller Fisher syndrome and he was commenced on intravenous immunoglobulins. Subsequently he developed shortness of breath due to inability to maintain airway secondary to bulbar dysfunction. Review of MRI brain revealed enhancement of basal meninges with contrast suggestive of entrapment of cranial nerves. CSF showed 760 lymphocytes and elevated protein at 1.2 g/L. Immunophenotyping revealed the lymphocytes to be of Natural Killer (NK) cell origin leading to diagnosis of relapse of lymphoma involving CNS. He was diagnosed ten months ago with extranodal nasal NK/T cell lymphoma involving paranasal sinuses which is a rare subtype of NHL and is associated with Epstein-Barr virus. He was treated with four cycles of SMILE chemotherapy and local radiotherapy and had achieved complete remission as evidenced by a negative PET CT scan three months ago. This case stresses the importance of considering CNS relapse as a differential in patients presenting with neurological symptoms and history of lymphoma even though CNS relapse is rare for NHL (2.8%).

scholarly journals Neuropathy similar to Miller Fisher syndrome associated with primary Sjogren′s syndrome: Response to intravenous immunoglobulins

2006 ◽  
Vol 9 (2) ◽  
pp. 116
Author(s):  
Emine Genc ◽  
BulentOguz Genc ◽  
MustafaCihat Avunduk ◽  
HasanHuseyin Kozak ◽  
Nurhan Ilhan
Keyword(s):  
Intravenous Immunoglobulins ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome
Sign in / Sign up

Export Citation Format

Share Document