title: Miller fisher syndrome presents as an acute voice change to hypernasal speech.
abstract: The authors describe a 38-year-old man who presented with hypernasality, perioral and acroparesthesia, dyspnea, and dysphagia. Further evaluation revealed a diagnosis of Miller-Fisher syndrome (MFS). MFS is a variant of Guillain-Barré syndrome previously described in neurology and critical care journals; however, there is a paucity of work concerning this disease in the otolaryngology literature. An acute change in voice usually occurs secondary to inflammatory processes as seen after intubation and infection, but can occur as part of a more complex disease entity such as Guillain-Barré or Miller-Fisher syndrome. As such, clinicians should consider this in their evaluation of rhinolalia aperta.
authors.affiliation: Department of Otolaryngology, George Washington University, 2150 Pennsylvania Ave., NW, Suite 6-301, Washington, DC 20037, USA. rjhowell@gwu.edu
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Howell
authors.forename: Alexandra G
authors.initials: AG
authors.lastname: Davolos
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Clary
authors.forename: Paul C
authors.initials: PC
authors.lastname: Frake
authors.forename: Arjun S
authors.initials: AS
authors.lastname: Joshi
authors.forename: Houtan
authors.initials: H
authors.lastname: Chaboki
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000175:diagnosis; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis; D006801:Humans; D006987:Hypesthesia / Q000175:diagnosis; D007564:Japan; D008297:Male; D019846:Miller Fisher Syndrome / Q000175:diagnosis*; D009460:Neurologic Examination; D010160:Palate, Soft / Q000294:innervation; D010292:Paresthesia / Q000175:diagnosis; D013064:Speech Disorders / Q000175:diagnosis*; D014195:Travel; D014481:United States; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis; D014832:Voice Disorders / Q000175:diagnosis*; D014833:Voice Quality