Miller-Fisher综合征(Miller-Fisher syndrome,MFS)是吉兰-巴雷综合征(Guillain-Barre syndrome,GBS)的一种临床变异型,以共济失调、眼肌麻痹及腱反射消失为主要临床特征,极少出现瞳孔改变和瞳孔对光反射异常,一般无症状波动,部分患者可检测到抗GQ1b IgG抗体阳性.本文报告了1例抗GQ1b、GT1a、Sulfatide抗体阳性的MFS,以波动性眼外肌麻痹起病,伴双侧瞳孔散大、对光反射迟钝及四肢麻木无力,症状少见不典型,临床极易误诊.
Miller Fisher syndrome(MFS)is a clinical variant of Guillain-Barre syndrome(GBS)and has the main clinical features of ataxia,ophthalmoplegia,and tendon areflexia,with pupil changes and abnormal pupillary light reflex in rare cases.There are generally no symptom fluctuations,and positive anti-GQ1b IgG antibodies can be detected in some patients.This article reports a case of MFS with positive anti-GQ1b,anti-GT1a,and anti-sulfatide antibodies and fluctuating extraocular muscle paralysis as the initial presentation,accompanied by bilateral pupil dilation,delayed light reflex,and numbness and weakness in the limbs.The symptoms are rare and atypical,which may easily lead to misdiagno-sis in clinical practice.