Pune: A 33-year-old man from Pune was diagnosed with a rare neurological condition known as Miller Fisher Syndrome and successfully treated at Manipal Hospital, Baner. The previously healthy 33-year-old patient presented to the hospital with complaints of sudden difficulty in walking and tingling sensation in both hands and legs. On careful examination, it was noted that he had drooping of the eyelids and mild difficulty in swallowing.
The condition raised suspicion of Miller-Fisher Syndrome (MFS), an uncommon variant of the Guillain-Barré syndrome (GBS). MFS is a rare neurological disease, affecting 1 – 2 people per million each year. It often occurs several days (up to four weeks) after a bacterial or viral illness. It is an autoimmune disease, in which the immune system attacks the nerves. It causes weakness of the eye muscles causing difficulty moving the eyes; impaired limb coordination and unsteadiness. It may develop into GBS with other features including facial, swallowing, and limb weakness.
In some patients, the disease may also progress rapidly cause difficulty in breathing, and necessitate use of ventilators and life support. However, this complication was averted as further testing was done rapidly to confirm the diagnosis in association with the radiology and pathology teams. Dr. Shruti Vadke (Consultant- Neurologist) began the treatment using intravenous immunoglobulins on the same day of admission. This medication regulates the immune system and neutralizes the harmful antibodies in the blood that attack the nerves.
Commenting on this case, Dr Shruti Vadke, a Consultant Neurologist, Manipal Hospital, Baner said, ” MFS can be challenging to diagnose as it can be mistaken with similar disorders with overlapping clinical features. Early detection and treatment are very important so that disease progression and complications can be avoided and also to prevent long-term disability.”
Before visiting Manipal Hospital, the patient visited another centre and underwent an MRI scan. Since the scan was normal, the cause of the symptoms remained unclear. After admission at Manipal Hospital, due to the prompt diagnosis and treatment, the patient eventually made a full recovery and was discharged without any residual disabilities.