Miller Fisher syndrome developed after a previous COVID-19 infection (case report)
https://doi.org/10.17650/2222-8721-2021-11-2-56-60
Abstract
Miller Fisher syndrome is one of the forms of Guillain–Barrе́ syndrome, characterized by a clinical triad that includes ophthalmoplegia, ataxia and areflexia, with the possible addition of moderate peripheral tetraparesis. During the year that has passed since the start of the pandemic of the new coronavirus infection COVID‑19, international publications have presented a few cases of Miller Fisher syndrome, which developed in patients at different times after the COVID‑19 infection – from 3–5 days to 3 weeks. The article presents a description of a clinical case of Miller Fisher syndrome, which occurred with 34‑year‑old man 21 days after the COVID‑19 infection. The clinical manifestations of Miller Fisher syndrome were typical and included diplopia, areflexia, and ataxia. At the beginning of the disease, there was a transient episode of speech impairment in the form of mild dysarthria. Oculomotor disorders predominated in the clinical picture over other components of the classical triad. On the background of treatment with human immunoglobulin G, there was a complete regression of symptoms.
This description of Miller Fisher syndrome, which developed after the postponed infection with COVID‑19, is the first in Russia. The presented case demonstrates the ability of the SARS‑CoV‑2 virus to induce the development of an autoimmune disease. Practitioners should take into account the possibility of Miller Fisher syndrome developing in the event of an acute onset of diplopia, ataxia and areflexia in patients after a previous COVID‑19 infection.
About the Authors
V. A. Malko
Almazov National Medical Research Centre
Russian Federation
Russian Federation
2 Akkuratov St., Saint Petersburg 197341
P. V. Klimov
Almazov National Medical Research Centre
Russian Federation
Russian Federation
2 Akkuratov St., Saint Petersburg 197341
M. P. Topuzova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Maria Petrovna Topuzova
2 Akkuratov St., Saint Petersburg 197341
I. V. Yarush
Almazov National Medical Research Centre
Russian Federation
Russian Federation
2 Akkuratov St., Saint Petersburg 197341
K. V. Simakov
Almazov National Medical Research Centre
Russian Federation
Russian Federation
2 Akkuratov St., Saint Petersburg 197341
T. M. Alekseeva
Almazov National Medical Research Centre
Russian Federation
Russian Federation
2 Akkuratov St., Saint Petersburg 197341
References
1. Abu-Rumeileh S., Abdelhak A., Foschi M. et al. Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases. J Neurol 2020;25:1–38. PMID: 32840686. DOI: 10.1007/s00415-020-10124-x.
2. Gomez A., Diaz A., Carrionn-Penagos J. et al. Clinical and electrophysiological characteristics of Guillain–Barré syndrome in Colombia. J Peripher Nerv Syst 2019;24(3):268–71. PMID: 31386254. DOI: 10.1111/jns.12340.
3. Hsueh H., Chang K., Chao C. et al. A pilot study on serial nerve ultrasound in Miller Fisher syndrome. Front Neurol 2020;11:865. PMID: 32922359. DOI: 10.3389/fneur.2020.00865.
4. Guarino M., Casmiro M., D’Alessandro R. Campylobacter jejuni infection and Guillain–Barré syndrome: a case-control study. Neuroepidemiology 1998;17(6):296–302. PMID: 9890808. DOI: 10.1159/000026183.
5. Bukhari S., Taboada J. A case of Miller Fisher syndrome and literature review. Cureus 2017;9(2):1048. PMID: 28367386. DOI: 10.7759/cureus.1048.
6. Lo Y.L. Clinical and immunological spectrum of the Miller Fisher syndrome. Muscle Nerve 2007;36(5):615–27. PMID: 17657801. DOI: 10.1002/mus.20835.
7. Leung J., Sejvar J.J., Soares J. et al. Guillain–Barré syndrome and antecedent cytomegalovirus infection, USA 2009–2015. Neurol Sci 2020;41(4):885–91. PMID: 31828680. DOI: 10.1007/s10072-019-04156-z.
8. Wijdicks E.F., Klein C.J. Guillain–Barré syndrome. Mayo Clin Proc 2017;92(3):467–79. PMID: 28259232. DOI: 10.1016/j.mayocp.2016.12.002.
9. Gutiérrez-Ortiz C., Méndez-Guerrero A., Rodrigo-Rey S. et al. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology 2020;95(5):601–5. PMID: 32303650. DOI: 10.1212/WNL.0000000000009619.
10. Inoue A., Koh C., Iwahashi T. Detection of serum anticerebellar antibodies in patients with Miller Fisher syndrome. Eur Neurol 1999;42(4):230–4. PMID: 10567821. DOI: 10.1159/000008113.
11. Chiba A., Kusunoki S., Shimizu T. et al. IgG antibody to ganglioside GQ1b is a possible marker of Miller Fisher syndrome. Ann Neurol 1992;31(6):677–9. PMID: 1514781. DOI: 10.1002/ana.410310619.
12. Suponeva N.A. Clinical and diagnostic role of autoantibodies to gangliosides of peripheral nerves: literature review and own experience. Neuromuscular Diseases 2013;(1):26–34. (In Russ.)]. DOI: 10.17650/2222-8721-2013-0-1-304-312.
13. Koga M., Yuki N., Takahashi M. et al. Close association of IgA anti-ganglioside antibodies with antecedent Campylobacter jejuni infection in Guillain–Barré and Fisher’s syndromes. J Neuroimmunol 1998;81(1–2):138–43. PMID: 9521615. DOI: 10.1016/s0165-5728(97)00168-9.
14. Nishimoto Y., Odaka M., Hirata K. et al. Usefulness of anti-GQ1b IgG antibody testing in Fisher syndrome compared with cerebrospinal fluid examination. J Neuroimmunol 2004;148(1–2):200–5. PMID: 14975602. DOI: 10.1016/j.jneuroim.2003.11.017.
15. Lantos J.E., Strauss S.B., Lin E. COVID-19-associated Miller Fisher syndrome: MRI findings. AJNR Am J Neuroradiol 2020;41(7):1184–6. PMID: 32467190. DOI: 10.3174/ajnr.A6609.
16. Kiphuth I.C., Saake M., Lunkenheimer J. et al. Bilateral enhancement of the cranial nerves III–XII in severe Miller Fisher syndrome. Eur Neurol 2009;62(4):252–3. PMID: 19672080. DOI: 10.1159/000232929.
17. Mao L., Jin H., Wang M. et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020;77(6):683–90. DOI: 10.1001/jamaneurol.2020.1127.PMID: 32275288.
18. Acharya A., Kevadiya B.D., Gendelman H.E. et al. SARS-CoV-2 infection leads to neurological dysfunction. J Neuroimmune Pharmacol 2020;15(2):167–73. PMID: 32447746. DOI: 10.1007/s11481-020-09924-9.
19. Lahiri D., Ardila A. COVID-19 pandemic: a neurological perspective. Cureus 2020;12(4):78–89. PMID: 32489743. DOI: 10.7759/cureus.7889.
20. Desforges M., LeCoupanec A., Dubeau P. et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system. Viruses 2020:12–4. DOI: 10.3390/v12010014
21. Bohmwald K., Galvez N., Ríos M. et al. Neurologic alterations due to respiratory virus infections. Front Cell Neurosci 2018; 12:386. DOI: 10.3389/fncel.2018.00386.
22. Gutiérrez-Ortiz C., Méndez-Guerrero A., Rodrigo-Rey S. et al. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology 2020;95(5):601–5. PMID: 32303650. DOI: 10.1212/WNL.0000000000009619.
23. Reyes-Bueno J.A., García-Trujillo L., Urbaneja P. et al. Miller Fisher syndrome after SARS-CoV-2 infection. Eur J Neurol 2020;27(9):1759–61. PMID: 32503084. DOI: 10.1111/ene.14383.
24. Senel M., Abu-Rumeileh S., Michel D. et al. Miller Fisher syndrome after COVID-19: neurochemical markers as an early sign of nervous system involvement. Eur J Neurol 2020;27(11):2378–80. PMID: 32781484. DOI: 10.1111/ene.14473.
25. Ray A. Miller Fisher syndrome and COVID-19: is there a link? BMJ Case Rep. 2020 Aug 11;13(8):e236419. PMID: 32784241. DOI: 10.1136/bcr-2020-236419.
26. Manganotti P, Pesavento V, Buoite Stella A, et al. Miller Fisher syndrome diagnosis and treatment in a patient with SARS-CoV-2. J Neurovirol 2020;26(4):605, 606. PMID: 32529516. DOI: 10.1007/s13365-020-00858-9.
27. Fernández-Domínguez J., AmeijideSanluis E., García-Cabo C. et al. Miller Fisher-like syndrome related to SARSCoV-2 infection (COVID 19). J Neurol 2020;267(9):2495, 2496. PMID: 32458195. DOI: 10.1007/s00415-020-09912-2.
28. Li Z., Li X., Shen J. et al. Miller Fisher syndrome associated with COVID-19: an up-to-date systematic review. Environ Sci Pollut Res Int 2021. PMID: 33677662. DOI: 10.1007/s11356-021-13233-w.
29. Wakerley B.R., Uncini A., Yuki N., et al. Guillain–Barré and Miller Fisher syndromes-new diagnostic classification. Nat Rev Neurol 2014;10(9):537–44. PMID: 25072194. DOI: 10.1038/nrneurol.2014.138.
30. Jung J.H., Oh E.H., Shin J.H. et al. Atypical clinical manifestations of Miller Fisher syndrome. Neurol Sci 2019;40(1):67–73. PMID: 30232672. DOI: 10.1007/s10072-018-3580-2.
31. Friedman D.I., Potts E. Headache associated with miller fisher syndrome. Headache 2007;47(9):1347–8. PMID: 17927654. DOI: 10.1111/j.1526-4610.2007.00935.x.
Review
For citations:
Malko V.A., Klimov P.V., Topuzova M.P., Yarush I.V., Simakov K.V., Alekseeva T.M. Miller Fisher syndrome developed after a previous COVID-19 infection (case report). Neuromuscular Diseases. 2021;11(2):56-60. (In Russ.) https://doi.org/10.17650/2222-8721-2021-11-2-56-60
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