title: The pescatorial sixth.
abstract: A 56-year-old man with diabetes presented with acute diplopia and signs of bilateral complete abduction deficits. Diffuse areflexia was his only other sign at presentation. Within a few days, he developed complete ophthalmoplegia and ataxia, consistent with a clinical diagnosis of Miller-Fisher syndrome, and repeated history revealed a possible gastroenteritis 3 weeks prior. This case illustrates an "ophthalmoplegia without ataxia" variant of this classic autoimmune condition, which should be considered in patients presenting with bilateral VI nerve palsies.
authors: Neuro-Ophthalmology Service, Department of Ophthalmology, Conegliano Hospital, Conegliano, Treviso, Italy. Electronic address: francepellegrini@virgilio.it.
authors: Francesco
authors: F
authors: Pellegrini
authors: Department of Ophthalmology, Conegliano Hospital, Conegliano, Treviso, Italy.
authors: Giovanni
authors: G
authors: Prosdocimo
authors: Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada; Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada.
authors: Jason J S
authors: JJ
authors: Barton
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy; D001259:Ataxia / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004172:Diplopia / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D009886:Ophthalmoplegia / Q000175:diagnosis* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007328:Insulin; D011239:Prednisolone
keywords: Miller-Fisher syndrome; areflexia; diplopia; ophthalmoplegia; sixth nerve palsy