American Academy of Ophthalmology
Miller Fisher syndrome consists of a triad of symmetrical ophthalmoplegia, severe ataxia and loss of tendon reflexes (Fisher, 1956). Smith et al recently reported a case of a 32-year-old man who presented with left-eyelid ptosis and ophthalmoplegia in all positions of gaze. The right eye was unaffected. He also had mild ataxia with tandem gait and absent tendon reflexes.
After a thorough workup, the patient was ultimately diagnosed with Miller Fisher syndrome. Positive anti-GQ1b antibodies verified the diagnosis. This case is important because general ophthalmologists often evaluate patients with monocular ophthalmoplegia and now should consider Miller Fisher syndrome in the differential diagnosis of such patients.
REFERENCES
Fisher M. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N Engl J Med. 1956;255(2):57–65.
Smith J, Clarke L, Severn P, Boyce R. Unilateral external ophthalmoplegia in Miller Fisher syndrome: case report. BMC Ophthalmol. 2007;7:7.