Tohoku J. Exp. Med., 2023 May, 260(1)

A Case of Miller Fisher Syndrome with Cerebellar Hypoperfusion

Kaori Sumi,¹ Noriyuki Kimura,¹ Yuko Watanabe,¹ Kenichi Yabuuchi¹ and Etsuro Matsubara¹

¹Department of Neurology, Graduate School of Medicine, Oita University, Yufu, Oita, Japan

We report a case of a 76-year-old man with Miller Fisher syndrome presenting with acute ophthalmoplegia and ataxia. Cerebrospinal fluid analysis showed normocytosis with an increased protein level. Serum anti-GQ1b IgG and anti-GT1a IgG antibodies were positive. Based on these results, the patient was diagnosed with Miller Fisher syndrome. He was treated with two courses of intravenous immunoglobulin, which improved his neurological symptoms. Brain perfusion single-photon emission computed tomography showed that cerebellar blood flow was decreased in the acute stage of the disease and improved after treatment. Although the prevailing view is that ataxia in Miller Fisher syndrome patients is of a peripheral origin, this case suggests that cerebellar hypoperfusion contributes to the development of ataxia in Miller Fisher syndrome.

Key words —— anti-GQ1b IgG antibody; ataxia; brain perfusion single-photon emission computed tomography; cerebellum; Miller Fisher syndrome

© 2023 Tohoku University Medical Press

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Tohoku J. Exp. Med 2023 May, 260(1), 47-50.

Correspondence: Kaori Sumi, Department of Neurology, Graduate School of Medicine, Oita University, 1-1 Idaigaoka, Hasama-cho, Yufu, Oita 879-5503, Japan.

e-mail: ka0941043@oita-u.ac.jp