A Case of Miller Fisher Syndrome Presenting as Sudden Vertigo

J Korean Neurol Assoc > Volume 18(4); 2000 > Article

Journal of the Korean Neurological Association 2000;18(4): 486-489.

갑자기 발생한 현훈을 주소로 내원한 Miller-Fisher 증후군 1예

홍삼남, 구자성 ·김병건 ·김석일 ·장덕민 ·배희준

을지의과대학 을지병원 신경과

A Case of Miller Fisher Syndrome Presenting as Sudden Vertigo

Sam-Nam Hong, M.D., Ja-Seong Koo, M.D., Byung-Kun Kim, M.D., Sug-Il Kim, M.D., Duck-Min Chang, M.D., Hee-Joon Bae, M.D.

Department of Neurology, Eulji General Hospital, Eulji University School of Medicine

Abstract

Ophthalmoplegia, ataxia, and areflexia are a classical triad of Miller Fisher syndrome (MFS). The experience of dizziness secondary to ophthalmoplegia is also not uncommon. However, nystagmus is rare and vertigo, a symptom of vestibulocerebellar dysfunction, has not been reported yet. A 56-year-old woman visited our hospital due to sudden vertigo. Initial examination revealed nystagmus evoked by a bilateral horizontal gaze with left side dysmetria. The next day, her symptoms rapidly aggravated to ophthalmoplegia, severe ataxia, areflexia, and quadriplegia. She was diag-nosed with MFS and was treated with intravenous immunoglobulin. On the fourth day, she developed respiratory fail-ure and a ventilator was applied. Twenty-eight days after her admission, she recovered to the point of walking without any aid and was discharged with minimal disability. There are still controversies surrounding the nosology of MFS and many investigators have reported evidence for brainstem involvement. Vertigo can be additional evidence for the involvement of the central nervous system in MFS. J Korean Neurol Assoc 18(4):486~489, 2000 Key Words : Miller fisher syndrome, Vertigo, Brainstem