Sindrome de Miller Fisher: relato de um caso

Scaff, Milberto; Marchiori, Paulo E.; Callegaro, Dagoberto; Assis, José Lamartine de

doi:10.1590/S0004-282X1982000300008

Resumos

Os autores relatam caso de um paciente de 34 anos de idade, sexo masculino com oftalmoplegia externa, ataxia severa, distúrbio de marcha, apalestesia e discreta alteração da sensibilidade superficial nas palmas das mãos e plantas dos pés. A força muscular era normal. Este quadro se iniciou no 15º dia após contrair infecção de vias aéreas superiores de provável causa viral. O paciente foi tratado com ACTH melhorando rapidamente.

The case of a man 34 year-old presenting upward gaze paralyses and external ophthalmoplegia without involvement of the downward gaze, accompanied by cerebellar disorders, generalized areflexia but no muscular weakness, and moderate sensory impairment of the four extremities is reported. The cerebrospinal fluid showed an albuminocytologic dissociation. Recovery was rapid and almost complete, within 3 weeks, remaining minimal paresis of the upward gaze and lateral movement in both eyes. The improvement had been coinciding with the treatment by cortrosina.

Sindrome de Miller Fisher: relato de um caso

Syndrome of Miller Fisher: a case report

Milberto Scaff^I; Paulo E. Marchiori^II; Dagoberto Callegaro^II; José Lamartine de Assis^III

^IAssistente. Departamento de Neuropsiquiatria, Divisão de Neurologia (Serviço do Prof. Horacio Martins Canelas) da Faculdade de Medicina da Universidade de São Paulo

^IILivre Docente. Departamento de Neuropsiquiatria, Divisão de Neurologia (Serviço do Prof. Horacio Martins Canelas) da Faculdade de Medicina da Universidade de São Paulo

^IIIProfessor Adjunto. Departamento de Neuropsiquiatria, Divisão de Neurologia (Serviço do Prof. Horacio Martins Canelas) da Faculdade de Medicina da Universidade de São Paulo

RESUMO

Os autores relatam caso de um paciente de 34 anos de idade, sexo masculino com oftalmoplegia externa, ataxia severa, distúrbio de marcha, apalestesia e discreta alteração da sensibilidade superficial nas palmas das mãos e plantas dos pés. A força muscular era normal. Este quadro se iniciou no 15º dia após contrair infecção de vias aéreas superiores de provável causa viral. O paciente foi tratado com ACTH melhorando rapidamente.

SUMMARY

The case of a man 34 year-old presenting upward gaze paralyses and external ophthalmoplegia without involvement of the downward gaze, accompanied by cerebellar disorders, generalized areflexia but no muscular weakness, and moderate sensory impairment of the four extremities is reported. The cerebrospinal fluid showed an albuminocytologic dissociation. Recovery was rapid and almost complete, within 3 weeks, remaining minimal paresis of the upward gaze and lateral movement in both eyes. The improvement had been coinciding with the treatment by cortrosina.

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Trabalho realizado no Departamento de Neuropsiquiatria, Divisão de Neurologia (Serviço do Prof. Horacio Martins Canelas) da Faculdade de Medicina da Universidade de São Paulo.

Departamento de Neurcpsiquiatria, Divisão de Neurologia - Faculdade de Medicina da. Universidade de São Paulo - Caixa Postal 3461 - 01000 São Paulo, SP - Brasil.

1. ARNOULD, G.; TRIDON, P.; SCHMITT, J. & GUERCI, O. - Polyradiculonévrite aigüé curables à forme ophthalmoplégique. Otoneuroophthal. 32:425, 1960.
2. BLAU, I.; CASSON. I.; LIEBERMAN, A. & WEISS, E. - The not-so-benign Miller Fisher syndrome. Arch. Neurol. (Chicago) 37:381, 1980.
3. ELIZAN, T. S.; SPIRE, J. P.; ANDIMAN, R. M.; BAUGHMAN, F. A. & LLOYD-SMITH, D. L. - Syndrome of acute idiopathic ophthalmoplegia with ataxia and areflexia. Neurology (Minneapolis) 21:281, 1971.
4. FISHER, M. - An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N. England J. Med. 255:57, 3956.
5. GIBBERD, F. B. - Ophthalmoplegia in acute polyneuritis. Arch. Neurol. (Chicago) 23:161, 1970.
6. GIBBERD, F. B. & KELLY, R. E. - Acute internal and external ophthalmoplegia with polyradiculitis of probable virus aetiology. Brain 87:657, 1964.
7. HAYMAKER, W. & KERNOHAN, J. W. - The Landry-Guillain-Barré syndrome: a clinicopathologic report of fifty fatal cases and a critique of the literature. Medicine 28:59, 1949.
8. HYNES, E. A. - Syndrome of Fisher: ophthalmoplegia, ataxia and areflexia. Amer. J. Ophthalm. 51:701, 1961.
9. MUNSA, T. T. L. & BARNES, J. E. - Relation of multiple cranial nerve dysfuntion to the Guillain-Barré syndrome. J. Neurol. Neurosurg. Psychiat. (London) 28:115, 1965.
10. NEUBERT, F. R. - Complete ophthalmoplegia in acute toxic polyneuritis. British J. Ophthal. 42:632, 1958.
11. QQUNDA, H. B. Y. TAYLOR, W. F. - Miller Fisher syndrome in a 22 month-old child. J. Pediat., 77:868, 1970.
12. SMITH, J. L. & WALSH, F. B. - Syndrome of external ophthalmoplegia, ataxia and areflexia (Fisher). Arch.. Ophthal. 58:109, 1957.
13. WIEDERHOLT, W. C; MULDER, D. W. & LAMBERT, H. - The Landry-Guillain-Barré-Sthohl syndrome or polyradiculoneuropathy: historical review, report on 97 patients and presente concepts. Mayo Clin. Proc. 39:427, 1964.
14. WILLIANS, D.; BRUST, J. C. M.; ABRAHMS, G.; CHALLENOR, Y. & DEVE-REAUX, M. - Landry-Guillain-Barré syndrome with abnormal pupils and normal eye movements: a case report. Neurology (Minneapolis) 29:1033, 1979.

Datas de Publicação

Publicação nesta coleção
16 Ago 2012
Data do Fascículo
Set 1982

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARNOULD, G.; TRIDON, P.; SCHMITT, J. & GUERCI, O. - Polyradiculonévrite aigüé curables à forme ophthalmoplégique. Otoneuroophthal. 32:425, 1960.

[2] 2. BLAU, I.; CASSON. I.; LIEBERMAN, A. & WEISS, E. - The not-so-benign Miller Fisher syndrome. Arch. Neurol. (Chicago) 37:381, 1980.

[3] 3. ELIZAN, T. S.; SPIRE, J. P.; ANDIMAN, R. M.; BAUGHMAN, F. A. & LLOYD-SMITH, D. L. - Syndrome of acute idiopathic ophthalmoplegia with ataxia and areflexia. Neurology (Minneapolis) 21:281, 1971.

[4] 4. FISHER, M. - An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N. England J. Med. 255:57, 3956.

[5] 5. GIBBERD, F. B. - Ophthalmoplegia in acute polyneuritis. Arch. Neurol. (Chicago) 23:161, 1970.

[6] 6. GIBBERD, F. B. & KELLY, R. E. - Acute internal and external ophthalmoplegia with polyradiculitis of probable virus aetiology. Brain 87:657, 1964.

[7] 7. HAYMAKER, W. & KERNOHAN, J. W. - The Landry-Guillain-Barré syndrome: a clinicopathologic report of fifty fatal cases and a critique of the literature. Medicine 28:59, 1949.

[8] 8. HYNES, E. A. - Syndrome of Fisher: ophthalmoplegia, ataxia and areflexia. Amer. J. Ophthalm. 51:701, 1961.

[9] 9. MUNSA, T. T. L. & BARNES, J. E. - Relation of multiple cranial nerve dysfuntion to the Guillain-Barré syndrome. J. Neurol. Neurosurg. Psychiat. (London) 28:115, 1965.

[10] 10. NEUBERT, F. R. - Complete ophthalmoplegia in acute toxic polyneuritis. British J. Ophthal. 42:632, 1958.

[11] 11. QQUNDA, H. B. Y. TAYLOR, W. F. - Miller Fisher syndrome in a 22 month-old child. J. Pediat., 77:868, 1970.

[12] 12. SMITH, J. L. & WALSH, F. B. - Syndrome of external ophthalmoplegia, ataxia and areflexia (Fisher). Arch.. Ophthal. 58:109, 1957.

[13] 13. WIEDERHOLT, W. C; MULDER, D. W. & LAMBERT, H. - The Landry-Guillain-Barré-Sthohl syndrome or polyradiculoneuropathy: historical review, report on 97 patients and presente concepts. Mayo Clin. Proc. 39:427, 1964.

[14] 14. WILLIANS, D.; BRUST, J. C. M.; ABRAHMS, G.; CHALLENOR, Y. & DEVE-REAUX, M. - Landry-Guillain-Barré syndrome with abnormal pupils and normal eye movements: a case report. Neurology (Minneapolis) 29:1033, 1979.