안검하수를 주소로 내원한 16세 남자환자

Abstract

A Case of Miller Fisher Syndrome 조영석, 김권, 김태수, 최혁중, 강보승, 임태호한양대학교 의과대학 응급의학과

Miller Fisher Syndrome N Eng J Med 1956;255;57-65 Definition & Diagnosis Described by Miller Fisher, M.D in 1956 Variant of Guillain-Barre Syndrome Autoimmune disease Diagnosed by Clinical presentation Ophthalmoplegia Ataxia Areflexia Albumino-cytologic dissociation in CSF study Nerve conduction velocity : decreased Serum Anti GQ1b Antibody in acute stage Clinical Presentation Antecedent respiratory or gastrointestinal infection History Clinical Triad : Ophthalmoplegia, Ataxia, Areflexia Diplopia, Paresthesia on Both extremities Facial motor weakness Limb motor weakness Respiratory failure Differential Diagnosis Intracranial vascular lesion (cerebral hemorrhage or infarction) CNS Infection (meningitis, encephalitis) Wernicke’s encephalopathy Brain tumor on brain stem, skull base Myasthenia gravis Treatment Conservative treatment IV Immunoglobulin, Plasmapheresis Most of case, self-limited