Ataxia in children mainly occurs from postinfectious cerebellar ataxia, toxic ingestions,
and labrynthitis. An unusual cause is the Miller Fisher syndrome (MFS) which is considered
a variant of Guillain-Barré syndrome. It is a self-limiting demyelinating disease
of the peripheral nervous system characterized by the triad of ophthalmoplegia, cerebellar
ataxia, and areflexia. We report on MFS in a child with review of the medical literature.
The medical literature was searched using MEDLINE/PubMed, Cochrane Library, and EMBASE.
The references from the articles were also reviewed. A 5-year-old girl presented with
difficulty walking, diplopia, and dysarthria. Her neurologic examination showed multiple
cranial palsies, marked truncal ataxia, and absent deep tendon reflex. Her respiratory
status worsened over 2 days, requiring orotracheal intubation. She ultimately was
diagnosed with MFS and was treated with intravenous IgG with improvement in her symptoms.
MFS is well described in adults and occasionally in children. It is associated with
elevated antiganglioside anti-GQ1b IgG antibody. Treatment is supportive with occasional
use of intravenous immunoglobulins or plasmapheresis in drug-resistant cases. Prognosis
is usually good, but on rare occasions, respiratory insufficiency may occur, and to
recognize its occurrence, frequent assessment of the respiratory status is required.
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Article Info
Publication History
Published online: July 25, 2016
Accepted:
July 20,
2016
Received in revised form:
July 18,
2016
Received:
July 16,
2016
Identification
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© 2016 Elsevier Inc. All rights reserved.
