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Miller Fisher syndrome with sinus arrest
Author(s) -
Nobuko Shiraiwa,
Mitsumasa Umesawa,
Sachiko Hoshino,
Tsuyoshi Enomoto,
Susumu Kusunoki,
Akira Tamaoka,
Norio Ohkoshi
Publication year - 2017
Publication title -
neurology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 16
ISSN - 2035-8377
DOI - 10.4081/ni.2017.7312
Subject(s) - dysautonomia , medicine , miller fisher syndrome , ataxia , bulbar palsy , magnetic resonance imaging , guillain barre syndrome , palsy , external ophthalmoplegia , anesthesia , cardiology , pediatrics , pathology , radiology , disease , biochemistry , chemistry , alternative medicine , psychiatry , gene , mitochondrial dna
Dysautonomia in Guillain-Barre syndrome (GBS) rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS) is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS

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