title: [Recurrent Miller-Fisher syndrome].
abstract: BACKGROUND
  Miller-Fisher syndrome (MFS) is a rare auto-immune post-infectious syndrome, characterized by an ataxia, an ophthalmoplegia and a generalized areflexia. It is considered as a clinical variant of Guillain-Barré syndrome (GBS). MFS is correlated with the presence of anti-GQ1b antibodies, elevated cerebrospinal fluid (CSF) protein levels, presence of mostly sensitive electrophysiological abnormalities and for some authors central involvement with increased signal intensity of brainstem and cerebellum on MRI. Recurrent MFS is extremely rare with only 21 cases since the first description in 1970.
  
  
  METHODS
  A 54-year-old women presented MFS with two episodes in 19 years. Clinically, the first episode was a "classical" MFS, and the second an extensive MFS with tetraparesis and respiratory failure. CSF protein levels and cerebral MRI were normal. Anti-GQ1b antibodies were strongly positive and anti-GM1, anti-GM2 antibodies were slightly positive, campylobacter jejuni serology was negative. Electromyography showed isolated sensory abnormalities in median nerves territory.
  
  
  CONCLUSIONS
  We report a new case of recurrent MFS with unusual clinical, biological and electrophysiological features.
authors.affiliation: Service de Neurologie, Centre Hospitalier A. Gayraud, Carcassonne. fabrice.battaglia@ch-carcassonne.fr
authors.forename: F
authors.initials: F
authors.lastname: Battaglia
authors.forename: F
authors.initials: F
authors.lastname: Attane
authors.forename: A
authors.initials: A
authors.lastname: Robinson
authors.forename: L
authors.initials: L
authors.lastname: Martini
authors.forename: J
authors.initials: J
authors.lastname: Siboni
authors.forename: C
authors.initials: C
authors.lastname: Tannier
mesh_terms: D000906:Antibodies / Q000276:immunology; D001259:Ataxia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D005732:Gangliosides / Q000276:immunology; D006801:Humans; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology; D012008:Recurrence; D012021:Reflex, Abnormal
chemical_list: D000906:Antibodies; D005732:Gangliosides; C060676:GQ1 ganglioside