Department of Neurology, National Institute of Neurology and Neurosurgery Dr. Manuel Velasco Suarez, Mexico City, Mexico.
Neuromuscular Disorders Clinic, National Institute of Neurology and Neurosurgery Dr. Manuel Velasco Suarez, Av. Insurgentes Sur 3877, Tlalpan, 14269, Mexico City, Mexico.
Neurol Sci. 2021 Oct;42(10):4225-4229. doi: 10.1007/s10072-020-05029-6. Epub 2021 Feb 16.
Classic and overlapping Miller-Fisher syndrome (MFS) have divergent clinical courses. Few studies have addressed the electrophysiological evaluation of MFS patients, most of them carried out in Asia. This work describes and compares their clinical and neurophysiological characteristics. From a Guillain-Barré syndrome (GBS) patient cohort, we made a selection of twenty MFS cases. We defined classic and overlapping MFS, as stated by Wakerley et al. (Nat Rev Neurol 10(9):537-544, 2014). We describe and compare clinical, biochemical, and electrodiagnostic parameters between groups. Seventy-five percent were men, mean age was 42.2 ± 13.6 years, and 45% had a Hughes score ≥ 3. MFS/GBS was the most frequent clinical subtype with 50%. Almost one-third had unaltered electrophysiological studies. Comparative analysis between groups showed statistically significant differences in length of stay, dysautonomia presence, and treatment type. Kaplan-Meier survival analysis showed that 100% of the patients had an independent walk at 3 months. This study reports Mexican MFS patient's characteristics and represents the most extensive case series in Latin America. We observed a high proportion of overlapping syndromes, a good recovery profile, and no significant severe complications.
经典型和重叠型米勒-费舍尔综合征(MFS)具有不同的临床病程。很少有研究涉及 MFS 患者的电生理评估,而且大多数研究都是在亚洲进行的。本研究描述并比较了他们的临床和神经生理特征。我们从吉兰-巴雷综合征(GBS)患者队列中选择了 20 例 MFS 病例。我们按照 Wakerley 等人的定义来区分经典型和重叠型 MFS(Nat Rev Neurol 10(9):537-544, 2014)。我们描述并比较了各组之间的临床、生化和电诊断参数。75%为男性,平均年龄为 42.2±13.6 岁,45%的患者 Hughes 评分≥3。MFS/GBS 是最常见的临床亚型,占 50%。近三分之一的患者的电生理研究未发生改变。组间比较分析显示,住院时间、自主神经功能障碍的存在和治疗类型存在统计学差异。Kaplan-Meier 生存分析显示,100%的患者在 3 个月时能够独立行走。本研究报告了墨西哥 MFS 患者的特征,是拉丁美洲最广泛的病例系列研究。我们观察到重叠综合征的比例较高,恢复良好,没有明显的严重并发症。