Pellegrini Francesco, Wang Margaret, Romeo Napoleone, Lee Andrew G
Neuro-Ophthalmology Service, Department of Ophthalmology, "De Gironcoli" Hospital, Conegliano, TV, Italy.
Blanton Eye Institute, Department of Ophthalmology, Houston Methodist Hospital, Houston, Texas, USA.
Neuroophthalmology. 2018 Jan 11;42(5):306-308. doi: 10.1080/01658107.2017.1420085. eCollection 2018 Oct.
A 6-year-old girl with acute pharyngitis presented with complaints of hypernasal speech and double vision. Examination revealed a bilateral abduction deficit associated with soft palate palsy causing rhinolalia aperta. Cerebrospinal fluid analysis showed albuminocytologic dissociation. Her sister also suffered from the same disorder, albeit milder, 1 month before. After treatment with intravenous immunoglobulin and steroids, the patient made a full recovery. After the case report, a brief discussion of Miller Fisher syndrome, Guillan-Barré syndrome, and their variants is made. This case highlights that bilateral sixth nerve palsy and rhinolalia aperta in the absence of ataxia should still raise suspicion for these autoimmune conditions that may rarely and atypically present in siblings.
一名患有急性咽炎的6岁女孩出现了鼻音过重和复视的症状。检查发现双侧外展功能障碍，伴有软腭麻痹导致开放性鼻音。脑脊液分析显示蛋白细胞分离。她的姐姐在1个月前也患有同样的疾病，不过症状较轻。经静脉注射免疫球蛋白和类固醇治疗后，患者完全康复。病例报告后，对米勒·费希尔综合征、格林-巴利综合征及其变体进行了简要讨论。该病例突出表明，在没有共济失调的情况下，双侧第六神经麻痹和开放性鼻音仍应引起对这些自身免疫性疾病的怀疑，这些疾病可能很少且非典型地出现在兄弟姐妹身上。
