Síndrome de Miller Fisher. A propósito de un caso / Miller Fisher syndrome. A case report
Abstract
El síndrome de Miller Fisher es una variedad clínica del síndrome de Guillain-Barré, que se caracteriza por oftalmoplejía, arreflexia y ataxia. Se presenta el caso de una paciente de 6 años de edad, atendida en el Hospital Pediátrico Docente Pepe Portilla de Pinar del Río, en noviembre de 2010; con antecedentes de salud anterior, que 5 días previos al inicio del cuadro tuvo una infección respiratoria alta aguda, seguida de un cuadro de debilidad bucofaríngea y facial, ataxia y debilidad muscular intensa de las extremidades. Se interconsulta con el servicio de Neurología, donde se constata diplejía facial periférica, parálisis del IV par izquierdo, ataxia e hiporreflexia; se le realizan varias investigaciones e ingresa en la Unidad de Cuidados Intensivos con el diagnóstico de síndrome de Miller Fisher. Se comienza el tratamiento con terapéuticocon, intacglobin y vitaminoterapia, logrando una evolución satisfactoria de la paciente a los 10 días de su ingreso en el servicio de UCI con regresión del cuadro.
DeCS: SÍNDROME DE MILLER FISHER (SMF)/complicaciones, SÍNDROME DE GUILLAIN-BARRÉ (SGB)/diagnóstico, INFECCIÓN, EVOLUCIÓN.
ABSTRACT
Miller Fisher syndrome is a clinical variant of Guillain-Barré syndrome it is characterized by ophthalmoplegia, areflexia and ataxia. A six-year old female patient attended to "Pepe Portilla" Children Hospital, Pinar del Rio in November 2010; with past health records, who 5 days before the onset of the disorder suffered from an acute upper respiratory infection that was followed by a picture of buccopharyngeal and facial weakness, ataxia and acute muscular debility of the limbs. A referral to Neurology service verified peripheral facial diplegia, paralysis of the IV left pair, ataxia and hyporeflexia; several examinations were performed before admitting her to the Intensive Care Unit (ICU) with the diagnosis of Miller Fisher syndrome. The therapeutic treatment included intacglobin and vitamins, achieving a satisfactory progress; the patient was discharged from the ICU 10 days after her admission with a total regression of the clinical picture.
DeCS: Miller Fisher Syndrome (MFS)/complications, Gillain-Barré Syndrome (GBS)/diagnosis, infection, evolution.
Downloads
References
1. Fisher M. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N Eng J Med. 1956; 255:57-65.
2. Torrent LS, Julian AN, Dueñas BP, Osorio AN, Oferil JC. Síndrome de Miller Fisher en la edad pediátrica: descripción de 3 casos.
An Pediatr Barc. 2009 oct; 71(4): 377-8.
3. Padilla-Parrado F, García-Casares N, Heras-Pérez JA, Sempere-Fernandez J, Serrano-Castro V, Romero-Acebal M. Síndrome de Miller Fisher como presentación de una encefalopatía de Wernicke. Rev Neurol. [serie en Internet] 2008 Apr. [Acceso 20 de diciembre de 2010]; 46(8): [Aprox. 3p.]. Disponible en: http://dialnet.unirioja.es/servlet/articulo?codigo=2577410
4. Cerisola-Cardoso A, Capote-Moreira G, Scavone-Mauor C. Síndrome de Guillain-Barré en pediatría. Diferentes formas de presentación y dificultades en el diagnóstico precoz. Rev Neurol. [serie en Internet] 2007. [Acceso 20 de diciembre de 2010]; 44(12): [aprox. 7p.] Disponible en: http://dialnet.unirioja.es/servlet/articulo?codigo=2327691
5. Fenichel GM. Ataxia. In: Clínical pediatric neurology. A signs and symtpoms approach. 5a. ed. Philadelphia: Elsevier Saunders; 2005.p. 219-37.
6. Torricelli RE. Síndrome de Guillain Barré en pediatría. Medicina. T-1.V-69. Buenos Aires; 2009.
7. Lestayo-O'Farrill Z, Hernández-Cáceres JL. Análisis del comportamiento del síndrome de Guillain-Barré. Consensos y discrepancias. Rev Neurol. [Serie en Internet] 2008. [Acceso 20 de diciembre de 2010]; 46(4): [Aprox. 7p.]. Disponible en: http://dialnet.unirioja.es/servlet/articulo?codigo=2550548
8. Kaida K, Kanzaki M, Morita D, Kamakura K, MotoyoshiK, Hirakawa M, et al. Anti-ganglioside complex antibodies in Miller Fisher syndrome. J Neurol Neurosurg Psychiatry. [Serie en Internet] 2006. [Acceso 20 de diciembre de 2010]; 77(9): [Aprox. 3p.] Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/16614007
9. Vilas E, Fernandez JM, Navarro C, Suárez L, García de Lorenzo A. Síndrome neuromuscular del paciente crítico. Rev Neurol. [Serie en Internet] 2006. [Acceso 20 de diciembre de 2010]; 42(11): [Aprox. 6p.] Disponible en: http://dialnet.unirioja.es/servlet/articulo?codigo=2008921
10. Agrawal S, Peake D, Whitehouse WP. Management of children with Guillain-Barré syndrome. Arch Dis Child Educ Pract Ed. [Serie en Internet] 2007. [Acceso 3 de mayo de 2008]; 92: [aprox. 7p.] Disponible en: http://ep.bmj.com/content/92/6/161.extract
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/