Ann Clin Neurophysiol.  2020 Oct;22(2):117-120. 10.14253/acn.2020.22.2.117.

Miller Fisher syndrome in a patient with pulmonary tuberculosis

• Park JY
• Jung HJ
• Bae H
• Han JH
• Kang MJ

• KMID: 2511088
• DOI: http://doi.org/10.14253/acn.2020.22.2.117

Abstract

Miller Fisher syndrome (MFS) is characterized by the acute ophthalmoparesis, ataxia and areflexia. We describe the case of 70-year-old man with cardinal symptom of MFS and active pulmonary tuberculosis (Tb). A thorough evaluation led to the diagnosis of MFS and treatment with intravenous immunoglobulin (IVIg) was started. The complete resolution of ophthalmoparesis and ataxia was observed from the fourth day of IVIg treatment. This is the first report to describe a case of MFS that developed in patient pulmonary tuberculosis.

Keyword

Miller Fisher syndrome; Tuberculosis; Guillain-Barré syndrome

Figure

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  Fig. 1. Initial chest X-ray (A) and low-dose chest computed tomography scan (B) showing patch consolidations and diffuse nodules in both upper lobes, suggesting active pulmonary tuberculosis.

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  Fig. 2. Extraocular movement in nine cardinal gazes: (A) at 7 days after symptom onset there were left ptosis, limitation of depression, and slight limitation of adduction in the left eye; and (B) at 14 days after symptom onset there were improvements in the left ptosis and extraocular movement limitation. The patient consented to the use of these photographs.

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