miller fisher syndrome

Summary

Summary: A variant of the GUILLAIN-BARRE SYNDROME characterized by the acute onset of oculomotor dysfunction, ataxia, and loss of deep tendon reflexes with relative sparing of strength in the extremities and trunk. The ataxia is produced by peripheral sensory nerve dysfunction and not by cerebellar injury. Facial weakness and sensory loss may also occur. The process is mediated by autoantibodies directed against a component of myelin found in peripheral nerves. (Adams et al., Principles of Neurology, 6th ed, p1313; Neurology 1987 Sep;37(9):1493-8)

Top Publications

  1. Yuki N, Odaka M, Hirata K. Acute ophthalmoparesis (without ataxia) associated with anti-GQ1b IgG antibody: clinical features. Ophthalmology. 2001;108:196-200 pubmed
    ..To examine the clinical features of acute ophthalmoparesis (AO) (without ataxia) associated with anti-GQ1b immunoglobulin G (IgG) antibody...
  2. Kambara C, Matsuo H, Fukudome T, Goto H, Shibuya N. Miller Fisher syndrome and plasmapheresis. Ther Apher. 2002;6:450-3 pubmed
    Treatment for Miller Fisher syndrome (MFS) is controversial, and even the natural history and prognosis are not fully understood. We retrospectively reviewed our cases of MFS for the last 3 years...
  3. Houliston R, Koga M, Li J, Jarrell H, Richards J, Vitiazeva V, et al. A Haemophilus influenzae strain associated with Fisher syndrome expresses a novel disialylated ganglioside mimic. Biochemistry. 2007;46:8164-71 pubmed
    ..The display by DH1, of a surface glycan that mimics the terminal trisaccharide portion of disialosyl-containing gangliosides, provides strong evidence for its involvement in the development of Fisher syndrome...
  4. Yuki N. Ganglioside mimicry and peripheral nerve disease. Muscle Nerve. 2007;35:691-711 pubmed
    ..Acute and chronic inflammatory demyelinating polyneuropathies may be produced by mechanisms other than ganglioside mimicry...
  5. Koga M, Gilbert M, Li J, Koike S, Takahashi M, Furukawa K, et al. Antecedent infections in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology. 2005;64:1605-11 pubmed
    ..To assess the production mechanism of anti-GQ1b autoantibody in Fisher syndrome (FS)...
  6. Willison H, O Hanlon G. The immunopathogenesis of Miller Fisher syndrome. J Neuroimmunol. 1999;100:3-12 pubmed
    Over the past decade, remarkable progress has been made in our understanding of the pathogenesis of Miller Fisher syndrome (MFS), a clinical variant of Guillain Barré syndrome (GBS)...
  7. Mori M, Kuwabara S, Yuki N. Fisher syndrome: clinical features, immunopathogenesis and management. Expert Rev Neurother. 2012;12:39-51 pubmed publisher
    ..The lesions responsible for the clinical symptoms have been debated but are close to clarification. Hence, the pathogenesis of FS has been made much clearer, although there are still some unanswered questions...
  8. Ito M, Kuwabara S, Odaka M, Misawa S, Koga M, Hirata K, et al. Bickerstaff's brainstem encephalitis and Fisher syndrome form a continuous spectrum: clinical analysis of 581 cases. J Neurol. 2008;255:674-82 pubmed publisher
  9. Lo Y. Clinical and immunological spectrum of the Miller Fisher syndrome. Muscle Nerve. 2007;36:615-27 pubmed
    The Miller Fisher syndrome (MFS), characterized by ataxia, areflexia, and ophthalmoplegia, was first recognized as a distinct clinical entity in 1956...

More Information

Publications62

  1. Mori M, Kuwabara S, Fukutake T, Hattori T. Intravenous immunoglobulin therapy for Miller Fisher syndrome. Neurology. 2007;68:1144-6 pubmed
    We analyzed clinical recovery of 92 patients with Miller Fisher syndrome who had been treated with IV immunoglobulin (IVIg; n = 28), plasmapheresis (n = 23), and no immune treatment (n = 41)...
  2. Dingle K, van den Braak N, Colles F, Price L, Woodward D, Rodgers F, et al. Sequence typing confirms that Campylobacter jejuni strains associated with Guillain-Barré and Miller-Fisher syndromes are of diverse genetic lineage, serotype, and flagella type. J Clin Microbiol. 2001;39:3346-9 pubmed
    ..These 4 isolates probably represented the Penner serotype 19 lineage, which has been proposed to have an association with GBS...
  3. Overell J, Willison H. Recent developments in Miller Fisher syndrome and related disorders. Curr Opin Neurol. 2005;18:562-6 pubmed
    b>Miller Fisher syndrome is a localized variant of Guillain-Barré syndrome, characterized by ophthalmoplegia, areflexia and ataxia...
  4. Yuki N, Susuki K, Hirata K. Ataxic Guillain-Barré syndrome with anti-GQ1b antibody: relation to Miller Fisher syndrome. Neurology. 2000;54:1851-3 pubmed
    ..Anti-GQ1b IgG antibodies from the patients, as well as from those with Miller Fisher syndrome (MFS), were absorbed by GT1a...
  5. San Juan O, Martínez Herrera J, García J, González Aragón M, Del Castillo Calcáneo J, Perez Neri I. Miller fisher syndrome: 10 years' experience in a third-level center. Eur Neurol. 2009;62:149-54 pubmed publisher
    There are few studies regarding the clinical characteristics of Miller Fisher syndrome (MFS) in the Latin-American population.
  6. Liu J, Willison H, Pedrosa Domellöf F. Immunolocalization of GQ1b and related gangliosides in human extraocular neuromuscular junctions and muscle spindles. Invest Ophthalmol Vis Sci. 2009;50:3226-32 pubmed publisher
    ..axial and limb muscles, and muscle spindles and thereby test the hypothesis that their distinctive ganglioside composition provides the molecular basis for selective involvement of EOMs and muscle spindles in Miller Fisher syndrome.
  7. Kimoto K, Koga M, Odaka M, Hirata K, Takahashi M, Li J, et al. Relationship of bacterial strains to clinical syndromes of Campylobacter-associated neuropathies. Neurology. 2006;67:1837-43 pubmed
  8. Stevenson V, Ferguson S, Bain P. Bickerstaff's brainstem encephalitis, Miller Fisher syndrome and Guillain-Barre syndrome overlap with negative anti-GQ1b antibodies. Eur J Neurol. 2003;10:187 pubmed
  9. Tezer F, Gurer G, Karatas H, Nurlu G, Saribas O. Involvement of the central nervous system in Miller Fisher syndrome: a case report. Clin Neurol Neurosurg. 2002;104:377-9 pubmed
    b>Miller Fisher syndrome (MFS) is characterised by ophthalmoplegia, ataxia and areflexia...
  10. Duim B, Ang C, van Belkum A, Rigter A, van Leeuwen N, Endtz H, et al. Amplified fragment length polymorphism analysis of Campylobacter jejuni strains isolated from chickens and from patients with gastroenteritis or Guillain-Barré or Miller Fisher syndrome. Appl Environ Microbiol. 2000;66:3917-23 pubmed
    ..jejuni strains associated with the development of Guillain-Barré syndrome (GBS) (n = 14) and Miller Fisher syndrome (MFS) (n = 4), two related acute paralytic syndromes in human, were included...
  11. Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T. Clinical features and prognosis of Miller Fisher syndrome. Neurology. 2001;56:1104-6 pubmed
    The authors reviewed the clinical features and outcome of Miller Fisher syndrome (MFS) for 50 consecutive patients with MFS including 28 patients who received no immunotherapy...
  12. Arai M, Odaka M, Yuki N, Hirata K. A patient with overlapping Bickerstaff's brainstem encephalitis, Miller Fisher syndrome and Guillain-Barré syndrome during the clinical course. Eur J Neurol. 2002;9:115-6 pubmed
  13. Tatsumoto M, Odaka M, Hirata K, Yuki N. Isolated abducens nerve palsy as a regional variant of Guillain-Barré syndrome. J Neurol Sci. 2006;243:35-8 pubmed
    ..Serum anti-GQ1b antibody was positive in 25. These findings suggest that some cases of isolated abducens nerve palsy can be categorized as a regional variant of Guillain-Barré syndrome or mild form of Fisher syndrome...
  14. Halstead S, Humphreys P, Zitman F, Hamer J, Plomp J, Willison H. C5 inhibitor rEV576 protects against neural injury in an in vitro mouse model of Miller Fisher syndrome. J Peripher Nerv Syst. 2008;13:228-35 pubmed publisher
    Guillain-Barré syndrome and its clinical variants, including the anti-GQ1b ganglioside-mediated Miller Fisher syndrome (MFS), comprise the world's leading cause of acute neuromuscular paralysis...
  15. Koga M, Yuki N, Tai T, Hirata K. Miller Fisher syndrome and Haemophilus influenzae infection. Neurology. 2001;57:686-91 pubmed
    To examine the association between Miller Fisher syndrome (MFS) and antecedent Haemophilus influenzae infection.
  16. Halstead S, Humphreys P, Goodfellow J, Wagner E, Smith R, Willison H. Complement inhibition abrogates nerve terminal injury in Miller Fisher syndrome. Ann Neurol. 2005;58:203-10 pubmed
    ..Using in vitro and in vivo models of the Guillain-Barré syndrome variant, Miller Fisher syndrome, we have shown previously that anti-GQ1b ganglioside antibodies target the presynaptic motor nerve ..
  17. Endtz H, Ang C, van den Braak N, Duim B, Rigter A, Price L, et al. Molecular characterization of Campylobacter jejuni from patients with Guillain-Barré and Miller Fisher syndromes. J Clin Microbiol. 2000;38:2297-301 pubmed
    ..has been identified as the predominant cause of antecedent infection in Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS). The risk of developing GBS or MFS may be higher after infection with specific C. jejuni types...
  18. Takahashi M, Koga M, Yokoyama K, Yuki N. Epidemiology of Campylobacter jejuni isolated from patients with Guillain-Barré and Fisher syndromes in Japan. J Clin Microbiol. 2005;43:335-9 pubmed
    ..HS:2 was more frequent in FS (41%) than in enteritis (14%) patients. These findings suggest that certain C. jejuni strains specifically trigger GBS and that others specifically trigger FS...
  19. Hsueh K, Chou I, Hsu C, Kuo H, Tsai F, Tsai C. Miller Fisher syndrome possibly related to mycoplasma pneumoniae infection: report of one case. Acta Paediatr Taiwan. 2004;45:168-70 pubmed
    ..and areflexia were first described in 1956 by Miller Fisher and later were referred to as symptoms of Miller Fisher syndrome (MFS)...
  20. Willison H. Ganglioside complexes as targets for antibodies in Miller Fisher syndrome. J Neurol Neurosurg Psychiatry. 2006;77:1002-3 pubmed
  21. Dorr J, Dieste F, Klaasen van Husen D, Zipp F, Vogel H. A case of recurrent Miller Fisher syndrome mimicking botulism. Neurol Sci. 2006;27:424-5 pubmed
    b>Miller Fisher syndrome (MFS) is a rare and usually monophasic polyradiculoneuropathy characterised by ophthalmoplegia, decreased or absent tendon reflexes, and ataxia...
  22. Durand M, Goulon Goeau C, Schweitzer A, Cheliout Heraut F, Raphael J, Gajdos P. [Electrophysiologic study of 10 cases of Miller Fisher syndrome]. Rev Neurol (Paris). 2001;157:72-9 pubmed
    ..It is postulated as a variant of the Guillain Barré syndrome. We report 10 Miller Fisher syndrome patients admitted in an intensive care unit between June 1990 and February 1999 who were selected ..
  23. Ang C, de Klerk M, Endtz H, Jacobs B, Laman J, van der Meche F, et al. Guillain-Barré syndrome- and Miller Fisher syndrome-associated Campylobacter jejuni lipopolysaccharides induce anti-GM1 and anti-GQ1b Antibodies in rabbits. Infect Immun. 2001;69:2462-9 pubmed
    ..are thought to induce antiganglioside antibodies in patients with Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS) by molecular mimicry between C. jejuni lipopolysaccharides (LPS) and gangliosides...
  24. Colding Jørgensen E, Vissing J. Visual impairment in anti-GQ1b positive Miller Fisher syndrome. Acta Neurol Scand. 2001;103:259-60 pubmed
    Autoimmune neuropathies such as the Guillain-Barré syndrome (GBS), the Miller Fisher syndrome (MFS), and chronic inflammatory demyelinating neuropathy (CIDP) have conventionally been considered diseases exclusively of the peripheral ..
  25. Sartucci F, Cafforio G, Borghetti D, Domenici L, Orlandi G, Murri L. Electrophysiological evidence by single fibre electromyography of neuromuscular transmission impairment in a case of Miller Fisher syndrome. Neurol Sci. 2005;26:125-8 pubmed
    b>Miller Fisher syndrome is an autoimmune neuropathy characterised by ataxia, areflexia and ophthalmoplegia, with minimal if any limb weakness, and in the majority of cases by high titres of IgG anti-GQ1b ganglioside antibodies...
  26. Sato S, Suzuki K, Nagao R, Kashiwagi Y, Kawashima H, Tsuyuki K, et al. Detection of MCP-1 and IL-8 in the serum and cerebrospinal fluid of a child with Miller Fisher syndrome. J Clin Neurosci. 2009;16:1698-9 pubmed publisher
    ..On examination she had ataxia, areflexia and ophthalmoplegia, and a diagnosis of Miller Fisher syndrome (MFS) was made after the exclusion of other conditions...
  27. Chan J. Optic neuritis in anti-GQ1b positive recurrent Miller Fisher syndrome. Br J Ophthalmol. 2003;87:1185-6 pubmed
  28. Loewenbrück K, Putz V, Schafer J, Reichmann H, Storch A. [Parainfectious polyneuropathy and miller-fisher-syndrome in combination with anemia in Mycoplasma pneumoniae infection]. Fortschr Neurol Psychiatr. 2008;76:361-5 pubmed publisher
    ..With this report we would like to stress the importance to include M.p. in the diagnostic procedures in the case of inflammatory neurological syndromes, especially when combined with alterations of the blood count...
  29. Li H, Yuan J. Miller Fisher syndrome: toward a more comprehensive understanding. Chin Med J (Engl). 2001;114:235-9 pubmed
    To review recent knowledge on the clinical features, pathology and pathophysiology, diagnosis and treatment of Miller Fisher syndrome (MFS).
  30. Yuki N. Infectious origins of, and molecular mimicry in, Guillain-Barré and Fisher syndromes. Lancet Infect Dis. 2001;1:29-37 pubmed
    ..Some patients develop FS after C jejuni infection, and the lipopolysaccharide present bears the GQ1b epitope. Molecular mimicry is a possible cause of GBS and FS...
  31. Aranyi Z, Kovacs T, Sipos I, Bereczki D. Miller Fisher syndrome: brief overview and update with a focus on electrophysiological findings. Eur J Neurol. 2012;19:15-20, e1-3 pubmed publisher
    b>Miller Fisher syndrome (MFS), a variant of the Guillain-Barré syndrome (GBS), is characterized by ophthalmoplegia, ataxia, and areflexia. The annual incidence is around one patient per one million population...
  32. Koga M, Koike S, Hirata K, Yuki N. Ambiguous value of Haemophilus influenzae isolation in Guillain-Barre and Fisher syndromes. J Neurol Neurosurg Psychiatry. 2005;76:1736-8 pubmed
    ..Haemophilus influenzae is considered a causative agent of Guillain-Barré syndrome (GBS) and Fisher syndrome, but the frequency of this infection in GBS is controversial...
  33. Koga M, Yuki N, Tsukada Y, Hirata K, Matsumoto Y. CDR3 spectratyping analysis of the T cell receptor repertoire in Guillain-Barré and Fisher syndromes. J Neuroimmunol. 2003;141:112-7 pubmed
    ..The predominant phenotypes vary, even within subgroups of patients with a syndrome of single etiological origin or those with uniform serological features...
  34. Colls B. Guillain-Barré syndrome and hyponatraemia. Intern Med J. 2003;33:5-9 pubmed
    ..Hyponatraemia is a recognized association of the Guillain-Barré syndrome (GBS) and is also known to occur after the administration of intravenous infusion of gamma globulin (IVIG), a treatment often used in management of GBS...
  35. Yuki N. Guillain-Barré syndrome and anti-ganglioside antibodies: a clinician-scientist's journey. Proc Jpn Acad Ser B Phys Biol Sci. 2012;88:299-326 pubmed
    ..In this review, I wanted to share my journey from being a clinician to a clinician-scientist in the hopes of inspiring younger clinicians to follow a similar path...
  36. Miyaishi M, Hemmi S, Hagiwara H, Murakami T, Sunada Y. [Collier's sign in Miller Fisher syndrome]. Rinsho Shinkeigaku. 2006;46:712-4 pubmed
    ..We report a case of Miller Fisher syndrome (MFS) which demonstrated Collier's sign...
  37. Costiniuk C, Le Saux N, Sell E, Doja A, Karnauchow T, Jacob P, et al. Miller Fisher syndrome in a toddler with influenza A (pH1N1) infection. J Child Neurol. 2011;26:385-8 pubmed publisher
    ..microorganism was responsible for this toddler's neurologic syndrome, this is the first reported case of Miller Fisher syndrome associated with pH1N1...
  38. Goto H, Matsuo H, Nakane S, Izumoto H, Fukudome T, Kambara C, et al. Plasmapheresis affects T helper type-1/T helper type-2 balance of circulating peripheral lymphocytes. Ther Apher. 2001;5:494-6 pubmed
    ..In 2 of 3 patients, plasmapheresis (immunoadsorption or plasma exchange) reduced Th1/Th2 cytokine ratio. The results may suggest that plasmapheresis induces a shift of Th1/Th2 balance in peripheral blood...
  39. Oyazato Y, Shiihara T, Kusunoki S, Adachi M, Ohnishi N, Taniguchi H, et al. A case of anti-GA1 antibody-positive Fisher syndrome with elevated tau protein in cerebrospinal fluid. Brain Dev. 2012;34:329-32 pubmed publisher
    ..In our patient, however, mild diplopia and areflexia persisted 6 months after their onset. Here, we report on the first Fisher syndrome patient with anti-GA1 antibody in the serum and elevated tau protein in the cerebrospinal fluid...
  40. Piusińska Macoch R. [Neurological complications during treatment of the tumor necrosis alpha inhibitors]. Pol Merkur Lekarski. 2013;34:293-7 pubmed
    ..Due to the emerging reports on the number of neurological adverse events of TNF antagonists, significantly higher than those described in the literature, the safety of their use requires further monitoring and multicenter studies...
  41. Ikuta N, Tada Y, Koga M. [Case of acute ophthalmoparesis with gaze nystagmus]. Rinsho Shinkeigaku. 2012;52:433-5 pubmed
    ..The ophthalmoparesis and nystagmus gradually disappeared in 3 months. The accompanying nystagmus suggests that central nervous system disturbance may also be present with acute ophthalmoparesis...
  42. Umapathi T, Tan E, Kokubun N, Verma K, Yuki N. Non-demyelinating, reversible conduction failure in Fisher syndrome and related disorders. J Neurol Neurosurg Psychiatry. 2012;83:941-8 pubmed publisher
    ..We hypothesised that such reversible conduction failure would be also observed in FS and related disorders...
  43. Lolekha P, Phanthumchinda K. Miller-Fisher syndrome at King Chulalongkorn Memorial Hospital. J Med Assoc Thai. 2009;92:471-7 pubmed
    ..Clinical spectrum, natural history, prognosis, and pathogenesis of MFS are not fully documented...
  44. Nakatani Y, Murata M, Shibata K, Nagaoka T, Utsunomiya I, Usuki S, et al. IgM anti-GQ1b monoclonal antibody inhibits voltage-dependent calcium current in cerebellar granule cells. Exp Neurol. 2009;219:74-80 pubmed publisher
    ..Therefore, the clinical symptoms of Miller-Fisher syndrome, such as cerebellar-like ataxia, may be explained by the inhibitory effects of anti-GQ1b antibodies on VDCC current in cerebellar granule cells...
  45. Makino F, Kojima Y, Inoue M, Satoi H, Kanda M, Shibasaki H, et al. [A case of Bickerstaff brainstem encephalitis concomitant with axonal Guillain-Barre syndrome and ballism successfully treated with intravenous immunoglobulin treatment]. Rinsho Shinkeigaku. 2008;48:501-4 pubmed
    ..It is thus conceivable that anti-GQ1b IgG antibody might underlie the pathogenesis of all three conditions...
  46. Sawanyawisuth K, Tiamkao S, Jitpimolmard S, Vincent A. A case of Miller Fisher syndrome with anti GQ1b in Thailand. J Med Assoc Thai. 2007;90:391-3 pubmed
    ..The patient was successfully treated with intravenous immunoglobulin and fully recovered within one month. After eighteen months follow-up, he is still healthy and has had no recurrent symptoms...
  47. Mak W, Chan K, Ho S. A case of ocular myasthenia gravis and Miller-Fisher syndrome. Hosp Med. 2005;66:116-7 pubmed
  48. McCurdy C, Davidson R, Cartee G. Brief calorie restriction increases Akt2 phosphorylation in insulin-stimulated rat skeletal muscle. Am J Physiol Endocrinol Metab. 2003;285:E693-700 pubmed
    ..There was no diet effect on SHIP2 abundance in skeletal muscle. These results suggest that, with brief CR, enhanced Akt2 phosphorylation may play a role in increasing insulin sensitivity in rat skeletal muscles...
  49. Ang C, Laman J, Willison H, Wagner E, Endtz H, de Klerk M, et al. Structure of Campylobacter jejuni lipopolysaccharides determines antiganglioside specificity and clinical features of Guillain-Barré and Miller Fisher patients. Infect Immun. 2002;70:1202-8 pubmed
    ..lipopolysaccharide (LPS) fraction of Campylobacter jejuni isolated from Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS) patients was compared with isolates from patients with an uncomplicated enteritis...
  50. Kim Y, Kim J, Jeong S, Park K, Kim S, Park S. Cerebral glucose metabolism in Fisher syndrome. J Neurol Neurosurg Psychiatry. 2009;80:512-7 pubmed publisher
    ..The aim of this study was to determine the involvement of the central nervous system in FS using (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET)...
  51. Silverstein M, Zimnowodzki S, Rucker J. Neuromuscular junction dysfunction in Miller Fisher syndrome. Semin Ophthalmol. 2008;23:211-3 pubmed publisher
    The Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome with the clinical triad of areflexia, ataxia, and ophthalmoparesis. The classic pathologic mechanism of disease is considered to be peripheral nerve demyelination...
  52. Cardenas D, Mishra S, Ohanian A, Ovbiagele B. Successive yet distinct episodes of isolated ophthalmoplegia associated with anti-GQ1b antibody. Neurology. 2005;65:163 pubmed
  53. Harukawa H, Utsumi H, Asano A, Yoshino H. Anti-LM1 antibodies in the sera of patients with Guillain-Barré syndrome, Miller Fisher syndrome, and motor neuron disease. J Peripher Nerv Syst. 2002;7:54-8 pubmed
    ..for the development of peripheral autoimmune neuropathies such as Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS)...