Neurology: Case of the Month

Test Yourself — Patient 19

Miller Fisher Syndrome (MFS)

1. The average age of onset is:
   • [ A ] 22.5
   • [ B ] 60
   • [ C ] 43.6
   • [ D ] 36
2. The following statement is TRUE regarding MFS:
   • [ A ] Occurs more often in females.
   • [ B ] Reflexes are usually normal.
   • [ C ] About two thirds of patients present with diplopia.
   • [ D ] Vertigo is a frequent complaint.
3. All of the following statements are TRUE, EXCEPT:
   • [ A ] The core syndrome consists of areflexia, ophthalmoplegia, and ataxia.
   • [ B ] A viral infection often precedes the symptoms.
   • [ C ] Botulism can present in a similar fashion.
   • [ D ] Proximal muscle weakness is not seen in MFS.
4. All of the following findings are consistent with MFS, EXCEPT:
   • [ A ] Absent H reflexes by EMG/NCV
   • [ B ] Elevated CSF protein
   • [ C ] Cranial nerve enhancement on imaging studies
   • [ D ] Abnormal ACE level
5. All of the following are correct regarding MFS, EXCEPT:
   • [ A ] The current belief is that the pathology is central.
   • [ B ] Campylobacter jejuni as well as antibodies to the ganglioside GQ1b are associated with MFS.
   • [ C ] Treatment is usually with plasmapheresis or intravenous immunoglobulins.
   • [ D ] Prognosis is good with recovery after a mean of 10 weeks.

 

Email comments: