Chae Choong Sik, Kwon Kyoung Min, Lee Jung Soo, Kim Yeo Hyung
Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Neurologist. 2018 Jul;23(4):128-130. doi: 10.1097/NRL.0000000000000183.
Patients with overlapping Miller Fisher syndrome (MFS), Guillain-Barré syndrome (GBS), and the Bickerstaff brainstem encephalitis (BBE) have rarely been reported, and the diverse clinical features and sequelae are challenging for physicians. Through this case report, we present the clinical course, treatment, recovery, and sequelae of an overlapping MFS, GBS, and BBE syndrome and provide a review of the literature.
A 76-year-old woman was initially presented with diplopia, ophthalmoplegia, and ataxia, but she later developed weakness of limbs, respiratory failure, deterioration of consciousness, and cognitive impairment. After IV immunoglobulin and corticosteroid therapy, she began to recover consciousness and from the weakness from day 18. After 8 months of rehabilitative therapy, she was able to swallow food without difficulty, but she still cannot walk without assistance, showed cognitive impairment, and the tracheostomy remained in place because of persistent respiratory muscle weakness.
As the clinical course of MFS-GBS-BBE overlapping syndrome is variable, involving not only the peripheral but also the central nervous system, the establishment of a comprehensive therapeutic strategy is warranted.
重叠型米勒-费雪综合征（MFS）、吉兰-巴雷综合征（GBS）和比克斯特费尔德脑干脑炎（BBE）的患者鲜有报道，其多样的临床特征和后遗症给医生带来了挑战。通过本病例报告，我们展示了一例重叠型MFS、GBS和BBE综合征的临床病程、治疗、恢复情况及后遗症，并对相关文献进行综述。
一名76岁女性最初出现复视、眼肌麻痹和共济失调，随后出现肢体无力、呼吸衰竭、意识障碍和认知障碍。经静脉注射免疫球蛋白和皮质类固醇治疗后，她于第18天开始意识恢复并从肢体无力中恢复。经过8个月的康复治疗，她能够顺利吞咽食物，但仍无法独立行走，存在认知障碍，且由于呼吸肌无力，气管切开术仍保留。
由于MFS-GBS-BBE重叠综合征的临床病程多变，不仅累及周围神经系统，还累及中枢神经系统，因此有必要制定全面的治疗策略。
