title: [Miller-Fisher syndrome: clinical features, associated infections and clinical course in 8 cases].
abstract: OBJECTIVE
  Miller-Fisher syndrome (MFS) is considered the most common variant of Guillain-Barré syndrome (GBS) and is characterized by the clinical triad of ophthalmoplegia, ataxia and areflexia. Respiratory involvement and relapses are unusual. Patients with MFS usually have a good recovery and no residual deficits. We describe the clinical features, associated infections and evolution in eight patients with MFS.
  
  
  METHODS
  Eight cases of MFS and sixty-one of GBS were studied between 1994 and 2003. All cases showed the clinical triad of MFS without major limb weakness or other signs suggestive of CNS involvement.
  
  
  RESULTS
  The proportion of MFS with respect to GBS during the same period was 13.1%. Four had a positive serology for Epstein-Barr virus, Salmonella enteritidis, Chlamydia pneumoniae and Mycoplasma pneumoniae. Our cases showed facial palsy (75%), dysphagia (75%), pupillary abnormalities (37.5%) and ventilation support (37.5%). Antiganglioside antibodies, determined in three cases (4 episodes), were positive [GQ1b (50%) and GD1b (50%)]. In all cases, there was a markedly reduced amplitude of the distal sensory as well as frequent axonal degeneration signs. The oldest three patients relapsed and required ventilation support.
  
  
  CONCLUSIONS
  We report for the first time an association between S. enteritidis and C. pneumoniae and MFS. Older patients in our series suffered a faster disease progression with need of ventilation support. We conclude that an older age correlates with poor prognosis and relapses.
authors.affiliation: Servicio de Neurología, Hospitales Universitarios Virgen del Rocío, Sevilla, España. juanj2000@vodafone.es
authors.forename: Juan Jesús
authors.initials: JJ
authors.lastname: Rodríguez Uranga
authors.forename: Francisco
authors.initials: F
authors.lastname: Delgado López
authors.forename: Emilio
authors.initials: E
authors.lastname: Franco Macías
authors.forename: María Bernal
authors.initials: MB
authors.lastname: Sánchez Arjona
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez Quesada
authors.forename: Alfredo
authors.initials: A
authors.lastname: Palomino García
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000150:complications* / Q000175:diagnosis*