Relapsing sensory ataxia initially manifested by miller-fisher syndrome

J Korean Neurol Assoc > Volume 15(1); 1997 > Article

Journal of the Korean Neurological Association 1997;15(1): 216-221.

Miller-fisher증후군으로 시작된 반복적인 감각성 운동 실조증

김병준, 서연림

삼성의료원 신경과

Relapsing sensory ataxia initially manifested by miller-fisher syndrome

B.Joon Kim, M.D., Yeon Lim Seo, M.D.

Department of Neurology and Pathology, Samsung Medical Center

Abstract

We experienced a patient who manifested Miller-Fisher syndrome initially, and progressed relapsing ataxia later, There was electrophysiologic evidence of distal sensory polyneuropathy with completely sparig of somatic motor nerves. Sural nerve biopsy showed severe segmental demyelination. All the symptoms improved by intravenous immunoglobulin dramatically but after a period of remission, progressive ataxia reappeared. Plama exchange had some effect and prednisolone alone showed no definite improvement. High dose of prednisolone combined with IVIgG made remission for a long time. We believe that this patient had an unusual form of inflammatory polyneuropathy, a relapsing variant of the Miller-Fisher syndrome of acute idiopathic polyneuritis. In this case, IVIgG was the most effective therapy and prednisolone was added as a long term therapy successfully.