P100 | A peculiar onset of sudden confusion and muscular weakness
Year: 2025
Type: article
Study design: Case Report
Abstract: Background: Miller Fisher-Bickerstaff Syndrome is an acute idiopathic polyneuritis characterized by the sudden onset of ataxia, ophthalmoplegia, areflexia, alterations of consciousness. It is more common in males, with an average onset age of 44 years. In 80-90% of patients antibodies against GT1a and GQ1b are present. Case report: A 55-year-old woman presented to the emergency room with fever, shaking chills, and abdominal pain. Abdominal CT revealed right pyelonephritis. During the hospitalization there was a sudden ideomotor slowdown, slurred speech, and persistent headache. She also exhibited a tendency to drowsiness and profound asthenia. Neurological examination revealed dysarthria, hypophonia, mild bilateral ptosis, diplopia on lateral gaze, easy fatigability of neck muscles and MingazziniI-II, with weak knee reflexes and absent Achilles reflexes. The search for anti-GT1a and GQ1b antibodies was negative. Electromyography indicated acute polyneuro-radiculopathy with predominant involvement of the upper limbs and facial region, with sign of possible involvement of the brainstem. Intravenous immunoglobulin (Igev) therapy was administered for 5 days, followed by a fast recovery. Conclusions: Miller Fisher syndrome is a rare form of Guillain-Barré syndrome, often triggered by an infection, typically respiratory, present in approximately 72% of cases, with an average latency of 10 days. Spontaneous complete recovery is usually achieved within 2-3 months of onset. Usually at 6 months no residual disabilities are observed.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413638776