In 1956, Dr. C. Miller Fisher first described Miller Fisher syndrome after seeing three patients who presented with absent tendon reflexes, ataxia (impaired coordination), and eye muscle weakness. Eventually, he defined this condition as a subtype or variant of Guillain-Barré syndrome (GBS). Since then, medical research has given us a more nuanced view of what Miller Fisher syndrome is. This rare, acquired nerve disease is considered to be a form of inflammatory demyelinating polyneuropathy. Let’s break this down a bit:
- Demyelinating: destruction of the myelin sheath (the protective covering of nerves)
- Polyneuropathy: damage or disease affecting multiple nerves throughout the body
So inflammatory demyelinating polyneuropathy means that inflammation causes the destruction of nerve coverings on multiple peripheral nerves. In some cases, an infection may trigger this inflammatory demyelination. The common cold, the flu, mononucleosis, and the Epstein-Barr virus (EBV) have all been associated with Miller Fisher syndrome. Doctors believe that the infection causes immune dysregulation; symptoms often appear within 4 weeks of infection. Vaccinations may, in rare cases, trigger this disease. In other cases, the cause is idiopathic (or unknown). Miller Fisher syndrome is most common in men, individuals in their 40s, and people of East Asian descent.
Using helpful insights from Dr. Heidi Moawad’s VeryWell Health article on Miller Fisher syndrome, Patient Worthy put together this educational guide to give you more insight into this rare disease.
What are the symptoms of Miller Fisher syndrome?
As described above, there are three characteristic symptoms of Miller Fisher syndrome: absent tendon reflexes, ataxia, and ophthalmoplegia (eye muscle weakness). Additional symptoms associated with this disease may include:
- Blurred or double vision
- Slurred speech
- Nystagmus (jerky or involuntary eye movements)
- Muscle weakness, often in the face and upper body
- Shortness of breath
- Difficulty chewing, speaking, or swallowing
- Headache
- Loss of taste sensation
How is Miller Fisher syndrome diagnosed?
Because Miller Fisher syndrome may appear similarly to other diseases, doctors must rule out conditions such as myasthenia gravis (MG), Bell’s palsy, progressive supranuclear palsy (PSP), and multiple sclerosis (MS). Doctors will use patient’s symptom histories and a physical exam to aid in the diagnosis. Additional tests such as blood tests, lumbar punctures, MRIs, muscle or nerve biopsies, and electromyography may also be utilized to aid in the diagnostic process.
