Guillain-Barré syndrome is an autoimmune disease that primarily affects muscle movement and can manifest itself in many variations.
In this article we will analyze symptoms, causes and treatment of Miller Fisher syndromeOne of the most common forms of this disorder.
What is Miller Fisher Syndrome?
Miller Fisher syndrome is a disease that affects the nervous system, causing it symptoms associated with muscle motility and coordination. In some cases, it can also cause alterations in other physiological systems.
This is one of the possible manifestations of Guillain-Barré syndrome, a collection of diseases that occur as a result of infections which in turn cause the immune system to malfunction.
Miller Fisher syndrome usually has a good prognosis: if appropriate medical treatment is applied symptoms tend to go away completely. However, this is not always the case, and if the damage to the nervous system is severe, there may be sequelae.
About twice as many cases of Miller Fisher syndrome are detected in women than in men, and the prevalence is higher in the spring than at other times of the year. The average age of onset of the disease is slightly over 40 years.
Guillain Barre syndrome
Guillain-Barré syndrome is an autoimmune disease; this means that it is made up of a faulty immune system which causes it to “attack” healthy cells in the body. In this case, the injuries take place in the peripheral nervous system, first affecting the muscles of the limbs and sometimes leading to complete paralysis.
In the most severe cases, this disease leads to death due to impaired functioning of the heart and respiratory systems. It is usually caused by viral infections, although the exact mechanisms by which it occurs are not known.
The differential diagnosis between Miller Fisher syndrome and other variants of Guillain-Barré syndrome is based on the presence of characteristic signs and symptoms. Let’s see what are the peculiarities of the subtype we are dealing with.
Main symptoms and signs
Three essential signs characterize Miller Fisher syndrome compared to other forms of Guillain-Barré syndrome: ataxia, areflexia and ophthalmoplegia. These changes usually appear 5 to 10 days after contracting a viral infection.
Ophthalmoplegia and ataxia are usually the first signs of the disease. The first is paralysis of the muscles of the eyeball while ataxia is defined as loss of motor coordination. For its part, the reflex, which intervenes in the third place and mainly in the limbs, is the absence of reflex movements.
The other idiosyncratic feature of this variant of Guillain-Barré syndrome is damage to the cranial nerve, which is associated with deficits in nerve conduction.
In some cases, there are other alterations associated with the same injuries, mainly generalized muscle weakness and respiratory deficits, Which can lead to death if the symptoms are very severe. However, these problems are more common in other forms of Guillain-Barré syndrome.
The causes of this disease
While Miller Fisher syndrome is often attributed to viral infections (and to a lesser extent also bacteria), the truth is that these have not been shown to be the only possible cause of this disease. .
The signs and symptoms are due to destruction of the myelin sheaths of peripheral nerves by the immune system. Myelin is a lipidic substance that covers the axons of certain neurons, allowing the efficient transmission of nerve impulses and increasing their speed.
However, alterations have also been detected in the central nervous system, particularly at the back of the spinal cord and brainstem.
On the other hand, it was found GBQ1b immunoglobulin antiganglioside antibody in most people diagnosed with Miller Fisher syndrome. This antibody appears to be particularly associated with the presence of ophthalmoplegia.
Processing and handling
Like other variants of Guillain-Barré syndrome, Miller Fisher disease is treated with two procedures: plasmapheresis, which involves removing antibodies from the blood by filtration and intravenous administration of immunoglobulins.
Both techniques are very effective in neutralizing the effects of pathological antibodies and in reducing inflammation, which also causes damage to the nervous system, but their combination does not significantly increase the chances of success of the procedure. however, administration of immunoglobulins is less risky.
Most people start to recover after two weeks to a month of treatment, provided it is applied early. After six months, symptoms and signs are usually zero or very rare, although sometimes there may be sequelae and there is a 3% risk of recurrence after resolution.