• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.156-159
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• 2001

Miller Fisher syndrome(MFS) has been the focus of conflicting opinions regarding the peripheral versus the central nature of the site of major neural injury. We present our electrophysiological findings in one case of MFS to help clarify the pattern of peripheral nerve injury in this syndrome. A 45-year-old man visited our hospital due to sudden diplopia. Initial examination revealed internuclear opthalmoplegia. The next day, his symptoms rapidly aggravated to complete external ophthalmoplegia, ataxia, and areflexia with hand and foot numbness. Serial electrophysiological studies were performed. The results of brainstem evoked potential(BAEP) and blink reflex were normal in the serial studies. Motor and sensory nerve conduction study(NCS) were normal findings in second hospital day, but ulnar sensory nerve shows no sensory nerve action potential(SNAP) and sural sensory conduction velocity was delayed in 7th hospital day. Our patient's clinical presentation began to improve on 15th hospital day, and his electrophysiologic study showed improvement on 29th hospital day. We believe that all the manifestations of MFS can be explained by the involvement of peripheral nerves without brainstem or cerebellar lesion with the serial electrophysiological studies.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.761-768
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• 2022

The purpose of this case report was to document the efficacy of Korean medicine as a treatment for Ophthalmoplegia of Miller-Fisher Syndrome. A 57-year-old male patient was treated with acupuncture, electropuncture, pharmacopuncture, and cupping treatments for 2 months. Symptom changes were evaluated using the Scott and Kraft score, photographs of eyeball movement, and the Yanagihara score. Korean medicine treatment significantly improved the eye movements, ncreased the Scott and Kraft score from -4 to 0, and improved the Yanagihara score from 20 to 32. Korean medicine treatment could effectively and quickly treat Ophthalmoplegia of Miller-Fisher Syndrome.

• The Journal of the Society of Stroke on Korean Medicine
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• v.20 no.1
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• pp.33-42
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• 2019

■ Objectives The purpose of this case report is to show the effect of Traditional Korean Medicine(TKM) on a patient with Miller Fisher Syndrome. ■ Methods A patient with Ataxia, Diplopia, Mydriasis diagnosed as Miller Fisher Syndrome was treated with herbal medication, acupuncture, electro-acupuncture, and press needles. Then we evaluated the improvement with the size of pupil, NRS(Numeral Rating Scale) of Diplopia, Assessment for Gait disturbance. ■ Results We could observe decrease in pupil size and NRS of Diplopia and improve in assessment for gait disturbance after the TKM treatment. ■ Conclusion This case showed the effect of TKM treatment on Miller Fisher syndrome.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.3
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• pp.84-98
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• 2024

Objective : The purpose of this study is to report that the effect of Korean medical treatments on Miller-Fisher Syndrome with ophtalmoplegia and facial palsy. Methods : We treated a 69-year-old female diagnosed with Miller-Fisher syndrome with ophthalmoplegia, right facial palsy and other symptoms. She received Korean medical treatments such as herbal medicine(Gamiboik-tang), cupping therapy and acupuncture(including pharmacopuncture). The severity of ophthalmoplegia was evaluated by length of the eyeball movement and Scott and Kraft score. The severity of facial palsy was evaluated by Yanagihara score and the severity of other symptoms such as diplopia, dizziness, gait disturbance and neck&shoulder pain was evaluated by VAS. Results : Each neurological symptoms were improved after Korean medical treatments. In case of ophthalmop legia, Scott and Kraft score increase from -4 to 0. There were no restrictions on eye movements. In case of facial palsy, Yanagihara score increased from 10 to 40. Also, other symptoms such as diplopia, dizziness, gait disturbance and neck&shoulder pain was improved. Conclusions : This case report suggests that Korean medical treatments can be effective for Miller-Fisher Syndrome patient with Ophthalmoplegia and Facial Palsy.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.51-53
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• 2011

Recently, we encountered a man with isolated bilateral sixth nerve palsies and areflexia whose titer of anti-GQ1b IgG antibody was elevated. We propose that bilateral sixth nerve palsies can be the sole manifestation of "anti-GQ1b antibody syndromes" and that patients with isolated bilateral sixth nerve palsies should be administered an anti-GQ1b antibody test for the diagnosis of acute immune-related neuropathy.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.4
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• pp.133-144
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• 2020

Objectives : The purpose of this study is to report the effect of Korean medicine treatment on limitation of eye movement in Miller-Fisher Syndrome. Methods : A patient was treated with herbal medicines, acupuncture(including electropuncture, phamacopuncture), Moxibustion and cupping therapy. To evaluate the result of this treatment, we used photographs of eye movement, Scott and Kraft score of both eye, length of eyeball movement and visual analogue scale(VAS) for subjective symptoms. Results : After treatment, the limitation of eye movement and diplopia were remarkably improved. Also, other symptoms such as dizziness, gait disturbance, facial nerve disorder were disappeared. Conclusions : This study suggests that Korean medicine treatments are effective for patient with limitation of eye movement in Miller-Fisher Syndrome.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.661-668
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• 2016

Objectives: To describe the effect of traditional Korean medicine and treatment on Miller Fisher syndrome (MFS).Methods: A 54-year-old woman diagnosed with MFS presented with eyeball dysfunction, diplopia, vertigo, right facial palsy, and back dysesthesia. The patient had been treated with immunoglobulin for 21 d, but her symptoms failed to improve. Thus, herbal medicine, acupuncture, electropuncture, pharmacopuncture, and moxibustion were added. Length of eyeball movement, distance that the patient recognize double images in the eyes and Visual Analogue Scale (VAS) are measures for the syndrome.Results: The symptoms of the patient considerably improved, with the return of eyeball movement to normal and disappearance of diplopia.Conclusions: The results suggest that Korean medicine may be an effective therapy for MFS.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.44-47
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• 2011

Background: Miller-Fisher syndrome (MFS) is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered a variant form of Guillain-Barre syndrome. Although some cases of delayed-onset facial palsy in MFS have been reported, the characteristics of this facial palsy are poorly described in the literature. Methods: Between 2007 and 2010, six patients with MFS were seen at our hospital. Delayed facial palsy, defined as a facial palsy that developed while the other symptoms of MFS began to improve following intravenous immunoglobulin treatment, was confirmed in four patients. The clinical and electrophysiological characteristics of delayed facial palsy in MFS, as observed in these patients, are described here. Results: Four patients with delayed-onset facial palsy were included. Delayed facial palsy developed 8-16 days after initial symptom onset (5-9 days after treatment). Unilateral facial palsy occurred in three patients and asymmetric facial diplegia in one patient. The House-Brackmann score of facial palsy was grade III in one patient, IV in two patients, and V in one patient. None of the patients complained of posterior auricular pain. Facial nerve conduction studies revealed normal amplitude in all four patients. The blink reflex showed abnormal prolongation in two patients and the absence of action potential formation in two patients. Facial palsy resolved completely in all four patients within 3 months. Conclusions: Delayed facial palsy is a frequent symptom in MFS and resolves completely without additional treatment. Thus, standard treatment and patient reassurance are sufficient in most cases.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.60-62
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• 2002

Two separate cranial nerve variants of Guillain-Barre syndrome(GBS) have been reported. One is Miller-Fisher syndrome, the other is polyneuritis cranialis. Involvement of the extraocular muscles in variants of GBS is well recognized, but complete external and internal opthalmoplegia is rare. Optic neuritis remains the only consistent, albeit very uncommon, evidence of inflammation of central nervous system myelin in GBS. This propose that GBS is part of a spectrum of central and peripheral inflammation. This case is an unusual clinical variant who had ptosis, opthalmoplegia, areflexia, ataxia, optic neurritis, marked oropharyngeal, and neck and shoulder weakness. This combined regional from is able to misdiagnose initially as botulism or diphtheria and less so, myasthenia. So if we were consider variant from of GBS, it is possible for make a correct diagnosis more easily and treatment without delay.

• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.119-124
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• 2002

Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is a neurologically emergent condition, leading to respiratory insufficiency without an early and appropriate treatment. Thus, the treatment of GBS requires early diagnosis but it is difficult due to the low sensitivity of laboratory tools in the initial stage. Hoffman reflex (H-reflex) and its facilitation by Jendrassik maneuver (JM) are sensitive tools evaluating the central circuit of motor system on the spinal cord level. The aim of this study is to test whether the change of H-reflex and F-wave under the JM is able to detect the early stage of GBS and whether GBS involves the central nervous system (CNS). Material and Methods : All 7 GBS patients who showed normal or nearly normal nerve conduction study were included. The facilitation of H-reflex and changes of F-wave were calculated by measuring the percent difference of H-reflex or F-wave amplitude under JM compared to basal H-reflex of F-wave amplitude. The changes of F-wave and H-reflex in the GBS patients were compared with them of 8 healthy controls. Results : The F-wave amplitudes of both healthy controls and GBS patients did not changed under the influence of JM ($102.4{\pm}24.9%$, $108.7{\pm}29.0%$ respectively). However, the facilitation of H-wave by JM in the GBS patients was absent ($98.8{\pm}5.8%$), even though the H-reflex amplitude I the healthy controls increased under the influence of JM ($124.8{\pm}12.1%$). Conclusions : The loss of H-reflex facilitation in GBS implies that this phenomenon might be the most early change detected in the electrophysiological study and support the early diagnosis, and that GBS might include lesion in the spinal motor CNS.