Abstract:
:Here, we describe a 79-year-old man, admitted to our unit for worsening diplopia and fatigue, started a few weeks after an episode of bronchitis and flu vaccination. Past medical history includes myasthenia gravis (MG), well-controlled by Pyridostigmine, Azathioprine, and Prednisone. During the first days, the patient developed progressive ocular movement abnormalities up to complete external ophthalmoplegia, severe limb and gait ataxia, and mild dysarthria. Deep tendon reflexes were absent in lower limbs. Since not all the symptoms were explainable with the previous diagnosis of myasthenia gravis, other etiologies were investigated. Brain MRI and cerebrospinal fluid analysis were normal. Electromyography showed a pattern of predominantly sensory multiple radiculoneuritis. Suspecting Miller Fisher syndrome (MFS), the patient was treated with plasmapheresis with subsequent clinical improvement. Antibodies against GQ1b turned out to be positive. MFS is an immune-mediated neuropathy presenting with ophthalmoplegia, ataxia, and areflexia. Even if only a few cases of MFS overlapping with MG have been described so far, the coexistence of two different autoimmune disorders can occur. It is always important to evaluate possible differential diagnosis even in case of known compatible diseases, especially when some clinical features seem atypical.
journal_name
Front Neuroljournal_title
Frontiers in neurologyauthors
Brusa R,Faravelli I,Gagliardi D,Magri F,Cogiamanian F,Saccomanno D,Cinnante C,Mauri E,Abati E,Bresolin N,Corti S,Comi GPdoi
10.3389/fneur.2019.00823subject
Has Abstractpub_date
2019-08-13 00:00:00pages
823issn
1664-2295journal_volume
10pub_type
abstract::[This corrects the article DOI: 10.3389/fneur.2020.563609.]. ...
journal_title:Frontiers in neurology
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