Identifier |
MFS_with_HYPER_DTR-Gold |
Title |
Miller Fisher Syndrome - Ophthalmoplegia and Hyperreflexia |
Alternative Title |
Video 4.29 Miller Fisher syndrome (MFS) causing ophthalmoparesis, sluggish pupils and imbalance from Neuro-Ophthalmology and Neuro-Otology Textbook |
Creator |
Daniel R. Gold, DO |
Affiliation |
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland |
Subject |
Range of Eye Movements/Motility Abnormal; Horizontal Gaze Palsy; Miller Fisher Syndrome |
Description |
𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-yo-woman who presented with mild imbalance and diplopia. There had been a preceding viral illness several weeks prior. Examination demonstrated horizontal gaze paresis (sparing unilateral adduction), mild gait ataxia (no clear appendicular ataxia), and hyperreflexia. Pupils were sluggish OU. Her anti-Gq1b antibodies came back very high and MFS was diagnosed. IVIG was given, and there was gradual improvement (of all symptoms/signs) back to her baseline over 3-6 months. While the typical triad includes ophthalmoplegia, ataxia, and HYPOreflexia, occasionally, HYPERreflexia is seen instead as in our patient. There may also be overlap between MFS and Bickerstaff's brainstem encephalitis - however, our patient had no symptoms or signs (aside from potentially her hyperreflexia) referable to the brainstem. Brain MRI was normal. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This is a 45 year-old woman who presented with mild imbalance and diplopia. There had been a preceding viral illness several weeks prior. Examination demonstrated horizontal gaze paresis (sparing unilateral adduction), mild gait ataxia (no clear appendicular ataxia), and hyperreflexia. Pupils were sluggish OU. Her anti-Gq1b antibodies came back very high and MFS was diagnosed. IVIG was given, and there was gradual improvement (of all symptoms/signs) back to her baseline over 3-6 months. While the typical triad includes ophthalmoplegia, ataxia, and HYPOreflexia, occasionally, HYPERreflexia is seen instead as in our patient. There may also be overlap between MFS and Bickerstaff's brainstem encephalitis - however, our patient had no symptoms or signs (aside from potentially her hyperreflexia) referable to the brainstem. Brain MRI was normal. https://collections. lib.utah.edu/ark:/87278/s62v64d2 |
Date |
2016 |
Language |
eng |
Format |
video/mp4 |
Type |
Image/MovingImage |
Collection |
Neuro-Ophthalmology Virtual Education Library: Dan Gold Neuro-Ophthalmology Collection: https://novel.utah.edu/Gold/ |
Publisher |
North American Neuro-Ophthalmology Society |
Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890 |
Rights Management |
Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
ARK |
ark:/87278/s62v64d2 |
File Name |
MFS_with_HYPER_DTR-Gold.mp4 |
Setname |
ehsl_novel_gold |
ID |
1209840 |
Reference URL |
https://collections.lib.utah.edu/ark:/87278/s62v64d2 |