Miller Fisher syndrome with sinus arrest

  • Nobuko Shiraiwa | shiraiwa@xa2.so-net.ne.jp Course of Neurology, Department of Health, Faculty of Health Sciences, Tsukuba University of Technology; Department of Neurology, Tsukuba Memorial Hospital, Japan.
  • Mitsumasa Umesawa Department of Neurology, Tsukuba Memorial Hospital; Department of Public Health, School of Medicine, Dokkyo Medical University, Japan.
  • Sachiko Hoshino Department of Neurology, Tsukuba Memorial Hospital, Japan.
  • Tsuyoshi Enomoto Department of Cardiology, Tsukuba Memorial Hospital, Japan.
  • Susumu Kusunoki Department of Neurology, Faculty of Medicine, Kindai University, Japan.
  • Akira Tamaoka Department of Neurology, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan.
  • Norio Ohkoshi Course of Neurology, Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Japan.

Abstract

Dysautonomia in Guillain-Barre syndrome (GBS) rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS) is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.

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Published
2017-08-29
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Section
Case Reports
Keywords:
Miller Fisher syndrome, Guillain- Barre syndrome, Dysautonomia, Sinus arrest
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How to Cite
Shiraiwa, N., Umesawa, M., Hoshino, S., Enomoto, T., Kusunoki, S., Tamaoka, A., & Ohkoshi, N. (2017). Miller Fisher syndrome with sinus arrest. Neurology International, 9(3). https://doi.org/10.4081/ni.2017.7312