PDF(Pubmed)
Abstract：
The etiopathogenesis for Guillain-Barré syndrome (GBS) and Miller-Fisher syndrome (MFS), a variant of GBS, is well-documented in the literature. However, the association between MFS and an underlying herpes simplex virus type 1 (HSV-1) infection is very limited. We present a unique case of a 48-year-old man who developed diplopia, bilateral ptosis, and gait instability following an acute diarrheal illness and recurring cold sores. The patient was diagnosed with MFS precipitated by recurrent HSV-1 infection following a Campylobacter jejuni acute infection. The diagnosis of MFS was supported by a positive anti-GQ1b ganglioside immunoglobulin (Ig)G and abnormal MRI-enhancing lesions of the bilateral cranial nerves III and VI. Intravenous immunoglobulin and acyclovir produced a significant clinical response in the patient within the first 72 hours. Our case highlights the rare association between two pathogens and MFS and the importance of recognizing risk factors, symptomatology, and appropriate workup accompanying an atypical MFS case.
摘要：
格林-巴利综合征（GBS）和米勒-费希尔综合征（MFS）的病因，GBS的一种变体，在文献中有很好的记载。然而,MFS与潜在的单纯疱疹病毒1型(HSV-1)感染之间的关联非常有限.我们提出了一个独特的案例，一个48岁的男性发展复视，双侧下垂,急性腹泻病和复发性唇疱疹后的步态不稳定。该患者被诊断为空肠弯曲杆菌急性感染后复发性HSV-1感染沉淀的MFS。MFS的诊断得到了抗GQ1b神经节苷脂免疫球蛋白（Ig）G阳性和双侧颅神经III和VI异常MRI增强病变的支持。静脉免疫球蛋白和阿昔洛韦在患者的前72小时内产生了显著的临床反应。我们的案例强调了两种病原体和MFS之间的罕见关联以及识别危险因素的重要性。症状学，以及伴随非典型MFS病例的适当检查。
