Nerve ultrasound in miller fisher variant of Guillain–Barré syndrome |
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| Authors: | Bernhard F. Décard MD Joachim Fladt MD Hubertus Axer MD Dirk Fischer MD Alexander Grimm MD |
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| Affiliation: | 1. Department of Neurology, Basel University Hospital, Basel, Switzerland;2. Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany;3. Division of Neuropaediatrics, University Children's Hospital Basel, Basel, Switzerland;4. University Clinic of Internal Medicine, Bruderholz, Switzerland;5. Department of Neurology and Epileptology, University of Tuebingen, Tuebingen, Germany |
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| Abstract: | Introduction: Focal enlargement of the peripheral and spinal nerves, visualized using high‐resolution ultrasound (HRUS), has been reported in early Guillain–Barré syndrome, but not in the Miller Fisher variant. We report the use of HRUS in 2 patients who presented with acute ataxic neuropathy, areflexia, and ophthalmoparesis. Methods: Ultrasound and/or nerve conduction studies (NCS) of peripheral nerves, the vagus, and spinal nerves C5/6 were performed at onset and 2 weeks after immunoglobulin therapy. Results: Both patients fulfilled criteria for diagnosis of Miller Fisher syndrome (MFS). Laboratory findings revealed elevated ganglioside Q1b antibodies in both and an albuminolocytologic dissociation in 1 patient. In addition, 1 patient had NCS evidence for demyelinating neuropathy. However, ultrasound showed focal enlargement in the vagus, the spinal nerves, and/or in the peripheral nerves in both patients. After therapy, nerve enlargement decreased in parallel with clinical improvement. Conclusion: Spinal and/or peripheral nerve enlargement supports the diagnosis of MFS in early phases of the disease. Muscle Nerve 52 : 1106–1110, 2015 |
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| Keywords: | nerve ultrasonography immune‐mediated neuropathy demyelinating polyneuropathy Miller– Fisher syndrome Guillain– Barré syndrome |
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