Miller Fisher Syndrome with Sinus Arrest
by
Nobuko Shiraiwa
1,2,*, 
Mitsumasa Umesawa
2,3,
Sachiko Hoshino
2,
Tsuyoshi Enomoto
4,
Susumu Kusunoki
5,
Akira Tamaoka
6 and
Norio Ohkoshi
1 1
Course of Neurology, Department of Health, Faculty of Health Sciences,Tsukuba University of Technology, Japan
2
Department of Neurology, Tsukuba Memorial Hospital, Japan
3
Department of Public Health, School of Medicine, Dokkyo Medical University, Japan
4
Department of Cardiology, Tsukuba Memorial Hospital, Japan
5
Department of Neurology, Faculty of Medicine, Kindai University, Japan
6
Department of Neurology, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan
*
Author to whom correspondence should be addressed.
Neurol. Int. 2017, 9(3), 7312; https://doi.org/10.4081/ni.2017.7312
Submission received: 14 July 2017
/
Revised: 14 July 2017
/
Accepted: 23 July 2017
/
Published: 29 August 2017
Abstract
Dysautonomia in Guillain-Barre syndrome (GBS) rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS) is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.
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MDPI and ACS Style
Shiraiwa, N.; Umesawa, M.; Hoshino, S.; Enomoto, T.; Kusunoki, S.; Tamaoka, A.; Ohkoshi, N. Miller Fisher Syndrome with Sinus Arrest. Neurol. Int. 2017, 9, 7312. https://doi.org/10.4081/ni.2017.7312
AMA Style
Shiraiwa N, Umesawa M, Hoshino S, Enomoto T, Kusunoki S, Tamaoka A, Ohkoshi N. Miller Fisher Syndrome with Sinus Arrest. Neurology International. 2017; 9(3):7312. https://doi.org/10.4081/ni.2017.7312
Chicago/Turabian StyleShiraiwa, Nobuko, Mitsumasa Umesawa, Sachiko Hoshino, Tsuyoshi Enomoto, Susumu Kusunoki, Akira Tamaoka, and Norio Ohkoshi. 2017. "Miller Fisher Syndrome with Sinus Arrest" Neurology International 9, no. 3: 7312. https://doi.org/10.4081/ni.2017.7312
