Tanaka Yuji, Satomi Kazuo
Department of Neurology, Gifu Municipal Hospital, Japan.
Intern Med. 2016;55(14):1917-8. doi: 10.2169/internalmedicine.55.6262. Epub 2016 Jul 15.
In this case report, we describe a patient with myasthenia gravis (MG) and Miller Fisher syndrome (MFS) overlap. A 69-year-old woman presented with acute bilateral ptosis, ophthalmoplegia, ataxic gait, and areflexia. The MFS diagnosis was confirmed with by a positive anti-GQ1b IgG antibody test result. MG was diagnosed from electrophysiological, edrophonium, and serological test results. Although intravenous immunoglobulin therapy is effective for both diseases, two courses of the therapy did not improve the patient's symptoms. However, steroid therapy was effective. Although the overlap of MG and MFS is very rare, it should be considered in the differential diagnosis of neuro-ophthalmic diseases.
在本病例报告中,我们描述了一名患有重症肌无力(MG)和米勒费雪综合征(MFS)重叠的患者。一名69岁女性出现急性双侧上睑下垂、眼肌麻痹、共济失调步态和腱反射消失。抗GQ1b IgG抗体检测结果呈阳性,确诊为MFS。根据电生理、依酚氯铵和血清学检测结果诊断为MG。虽然静脉注射免疫球蛋白疗法对这两种疾病均有效,但两个疗程的治疗并未改善患者症状。然而,类固醇疗法有效。尽管MG和MFS的重叠非常罕见,但在神经眼科疾病的鉴别诊断中应予以考虑。