Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy
A case report of a healthy young male, presented with binocular diplopia of sudden onset with mild bilateral abduction limitation, progressed rapidly to near total ophthalmoplegia. Rest of the ophthalmic examination, blood pressure, and magnetic resonance imaging of brain were normal. Basic blood wo...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Kerala Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.kjophthal.com/article.asp?issn=0976-6677;year=2023;volume=35;issue=3;spage=316;epage=318;aulast=Namitha |
| _version_ | 1797231756834766848 |
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| author | V G Namitha R Neena |
| author_facet | V G Namitha R Neena |
| author_sort | V G Namitha |
| collection | DOAJ |
| description | A case report of a healthy young male, presented with binocular diplopia of sudden onset with mild bilateral abduction limitation, progressed rapidly to near total ophthalmoplegia. Rest of the ophthalmic examination, blood pressure, and magnetic resonance imaging of brain were normal. Basic blood work-up was normal except mildly raised serum triglycerides. He gave a history of mild giddiness and ataxia. Neurological evaluation done showed absent deep tendon reflexes and serum anti-GQ1b antibody was raised. A diagnosis of Miller-Fisher syndrome was made and he was given intravenous immunoglobulin. Post-treatment his ocular motility recovered well, with minimal residual diplopia noted for distance. In individuals with abducent nerve palsy, normal imaging, and no systemic risk factors, a careful history asking for subtle neurological symptoms and a complete central nervous system examination is warranted to rule out conditions like Miller-Fisher syndrome which may not be a familiar entity to many ophthalmologists. |
| first_indexed | 2024-04-24T15:49:27Z |
| format | Article |
| id | doaj.art-91c3072d58ac4d04a6f8443fb5f294c8 |
| institution | Directory Open Access Journal |
| issn | 0976-6677 |
| language | English |
| last_indexed | 2024-04-24T15:49:27Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Kerala Journal of Ophthalmology |
| spelling | doaj.art-91c3072d58ac4d04a6f8443fb5f294c82024-04-01T12:58:19ZengWolters Kluwer Medknow PublicationsKerala Journal of Ophthalmology0976-66772023-01-0135331631810.4103/kjo.kjo_12_23Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsyV G NamithaR NeenaA case report of a healthy young male, presented with binocular diplopia of sudden onset with mild bilateral abduction limitation, progressed rapidly to near total ophthalmoplegia. Rest of the ophthalmic examination, blood pressure, and magnetic resonance imaging of brain were normal. Basic blood work-up was normal except mildly raised serum triglycerides. He gave a history of mild giddiness and ataxia. Neurological evaluation done showed absent deep tendon reflexes and serum anti-GQ1b antibody was raised. A diagnosis of Miller-Fisher syndrome was made and he was given intravenous immunoglobulin. Post-treatment his ocular motility recovered well, with minimal residual diplopia noted for distance. In individuals with abducent nerve palsy, normal imaging, and no systemic risk factors, a careful history asking for subtle neurological symptoms and a complete central nervous system examination is warranted to rule out conditions like Miller-Fisher syndrome which may not be a familiar entity to many ophthalmologists.http://www.kjophthal.com/article.asp?issn=0976-6677;year=2023;volume=35;issue=3;spage=316;epage=318;aulast=Namithaintravenous immunoglobulin (ivig)miller-fisher syndrome (mfs)serum anti-gq1b antibodysixth nerve palsy |
| spellingShingle | V G Namitha R Neena Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy Kerala Journal of Ophthalmology intravenous immunoglobulin (ivig) miller-fisher syndrome (mfs) serum anti-gq1b antibody sixth nerve palsy |
| title | Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy |
| title_full | Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy |
| title_fullStr | Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy |
| title_full_unstemmed | Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy |
| title_short | Fleeting diplopia and wobbly feet: Miller-Fisher syndrome-presenting as bilateral abducent nerve palsy |
| title_sort | fleeting diplopia and wobbly feet miller fisher syndrome presenting as bilateral abducent nerve palsy |
| topic | intravenous immunoglobulin (ivig) miller-fisher syndrome (mfs) serum anti-gq1b antibody sixth nerve palsy |
| url | http://www.kjophthal.com/article.asp?issn=0976-6677;year=2023;volume=35;issue=3;spage=316;epage=318;aulast=Namitha |
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