Literature DB >> 16155441

Recent developments in Miller Fisher syndrome and related disorders.

James R Overell1, Hugh J Willison.   

Abstract

PURPOSE OF REVIEW: Miller Fisher syndrome is a localized variant of Guillain-Barré syndrome, characterized by ophthalmoplegia, areflexia and ataxia. Bickerstaff's brainstem encephalitis is a related syndrome in which upper motor neurone features accompany the classic triad. Anti-GQ1b antibodies are uniquely found in both conditions and are believed to be pathogenic. RECENT
FINDINGS: Infectious illnesses usually precede Miller Fisher syndrome. The clearest associations have been described with Haemophilus influenzae and Campylobacter jejuni infection. Raised cerebrospinal fluid protein is seen in 60% of patients, but clinical features and anti-GQ1b antibody testing are diagnostically more informative. Experimental studies demonstrating complement-dependent neuromuscular block may be relevant to the clinical pathophysiology of Miller Fisher syndrome. Recent neurophysiological studies suggest abnormal neuromuscular transmission occurs in some cases of Miller Fisher syndrome and Guillain-Barré syndrome. Recent mouse models have demonstrated that presynaptic neuronal membranes and perisynaptic Schwann cells are targets for anti-GQ1b antibody attack. The elimination of antiganglioside antibodies from the circulation through specific immunoadsorption therapy has the potential to ameliorate the course of Miller Fisher syndrome. This condition is typically a benign, self-limiting illness. Both plasmapheresis and intravenous immunoglobulin may be employed as treatment, especially in cases of Bickerstaff's brainstem encephalitis or those with overlapping Guillain-Barré syndrome.
SUMMARY: Anti-GQ1b antibody testing has allowed clinicians to develop a greater understanding of the spectrum of Miller Fisher syndromes and to refine clinical diagnoses in patients with unusual presentations. Experimental studies strongly suggest anti-GQ1b antibodies are pathogenic, which in principle should direct treatments towards antibody neutralization or elimination.

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Year:  2005        PMID: 16155441     DOI: 10.1097/01.wco.0000173284.25581.2f

Source DB:  PubMed          Journal:  Curr Opin Neurol        ISSN: 1350-7540            Impact factor:   5.710


  16 in total

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Journal:  Neurotherapeutics       Date:  2012-01       Impact factor: 7.620

2.  Pathogenesis and treatment of immune-mediated neuropathies.

Authors:  Helmar C Lehmann; Gerd Meyer Zu Horste; Bernd C Kieseier; Hans-Peter Hartung
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3.  Miller Fisher Syndrome: A Case Report Highlighting Heterogeneity of Clinical Features and Focused Differential Diagnosis.

Authors:  Ilya V Yepishin; Randall Z Allison; David A Kaminskas; Natalia M Zagorski; Kore K Liow
Journal:  Hawaii J Med Public Health       Date:  2016-07

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Authors:  Betty Diamond; Patricio T Huerta; Paola Mina-Osorio; Czeslawa Kowal; Bruce T Volpe
Journal:  Nat Rev Immunol       Date:  2009-06       Impact factor: 53.106

Review 5.  Immunotherapy of Guillain-Barré syndrome.

Authors:  Shuang Liu; Chaoling Dong; Eroboghene Ekamereno Ubogu
Journal:  Hum Vaccin Immunother       Date:  2018-07-12       Impact factor: 3.452

Review 6.  Clinical relevance of terminal Schwann cells: An overlooked component of the neuromuscular junction.

Authors:  Katherine B Santosa; Alexandra M Keane; Albina Jablonka-Shariff; Bianca Vannucci; Alison K Snyder-Warwick
Journal:  J Neurosci Res       Date:  2018-03-13       Impact factor: 4.164

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Review 8.  [Guillain-Barré syndrome after exposure to influenza].

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