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Case Reports in Neurological Medicine
Volume 2012 (2012), Article ID 150813, 7 pages
http://dx.doi.org/10.1155/2012/150813
Case Report

Ataxia, Ophthalmoplegia, and Areflexia: What Would You Think?

1Neurology Department, St Georges Healthcare NHS Trust, London SW17 0QT, UK
2Clinical Neuropathology Department, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK

Received 5 March 2012; Accepted 28 April 2012

Academic Editors: A. Atri and A. Fasano

Copyright © 2012 N. Karsan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. C. J. Eberth, “Zur Entwickelung des Epithelioms (Cholesteatoms) der Pia und der Lunge,” Virchows Archiv, vol. 49, no. 1, pp. 51–63, 1869. View at Publisher · View at Google Scholar · View at Scopus
  2. W. F. Beerman, “The absence of brain tumour symptoms in cases of tumours of the brain,” California State Journal of Medicine, vol. 11, no. 6, pp. 234–235, 1913.
  3. W. R. Wasserstrom, J. P. Glass, and J. B. Posner, “Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients,” Cancer, vol. 49, no. 4, pp. 759–772, 1982. View at Scopus
  4. J. G. Kaplan, T. G. DeSouza, A. Farkash et al., “Leptomeningeal metastases: comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias,” Journal of Neuro-Oncology, vol. 9, no. 3, pp. 225–229, 1990. View at Publisher · View at Google Scholar · View at Scopus
  5. J. B. Posner, Neurologic Complications of Cancer, F. A. Davis, Philadelphia, Pa, USA, 1995.
  6. S. Kesari and T. T. Batchelor, “Leptomeningeal metastases,” Neurologic Clinics, vol. 21, no. 1, pp. 25–66, 2003. View at Publisher · View at Google Scholar · View at Scopus
  7. M. C. Chamberlain, “Carcinomatous meningitis,” Archives of Neurology, vol. 54, no. 1, pp. 16–17, 1997.
  8. J. P. Glass, M. Melamed, N. L. Chernik, and J. B. Posner, “Malignant cells in cerebrospinal fluid (CSF): the meaning of a positive CSF cytology,” Neurology, vol. 29, no. 10, pp. 1369–1375, 1979. View at Scopus
  9. W. R. Shapiro, J. B. Posner, and Y. Ushio, “Treatment of meningeal neoplasms,” Cancer Treatment Reports, vol. 61, no. 4, pp. 733–743, 1977. View at Scopus
  10. J. B. Posner and N. L. Chernik, “Intracranial metastases from systemic cancer,” Advances in Neurology, vol. 19, pp. 579–592, 1978. View at Scopus
  11. J. R. Little, A. J. D. Dale, and H. Okazaki, “Meningeal carcinomatosis: clinical manifestations,” Archives of Neurology, vol. 30, no. 2, pp. 138–143, 1974. View at Scopus
  12. R. A. Price and W. W. Johnson, “The central nervous system in childhood leukemia. I. The arachnoid,” Cancer, vol. 31, no. 3, pp. 520–533, 1973. View at Scopus
  13. B. Azzarelli, L. D. Mirkin, and M. Goheen, “The leptomeningeal vein. A site of re-entry of leukemic cells into the systemic circulation,” Cancer, vol. 54, no. 7, pp. 1333–1343, 1984. View at Scopus
  14. G. O. Grain and J. P. Karr, “Diffuse leptomeningeal carcinomatosis; clinical and pathologic characteristics,” Neurology, vol. 5, no. 10, pp. 706–722, 1955.
  15. B. G. Redman, E. Tapazoglou, and M. Al-Sarraf, “Meningeal carcinomatosis in head and neck cancer. Report of six cases and review of the literature,” Cancer, vol. 58, no. 12, pp. 2656–2661, 1986. View at Scopus
  16. J. L. Nugent, P. A. Bunn Jr., and M. J. Matthews, “CNS metastases in small cell bronchogenic carcinoma. Increasing frequency and changing pattern with lengthening survival,” Cancer, vol. 44, no. 5, pp. 1885–1893, 1979. View at Scopus
  17. R. S. Aroney, D. N. Dalley, and W. K. Chan, “Meningeal carcinomatosis in small cell carcinoma of the lung,” American Journal of Medicine, vol. 71, no. 1, pp. 26–32, 1981. View at Scopus
  18. R. Boyle, M. Thomas, and J. H. Adams, “Diffuse involvement of the leptomeninges by tumour - a clinical and pathological study of 63 cases,” Postgraduate Medical Journal, vol. 56, no. 653, pp. 149–158, 1980. View at Scopus
  19. M. Fisher, “An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia),” The New England Journal of Medicine, vol. 255, no. 2, pp. 57–65, 1956.
  20. B. C. Jacobs, H. P. Endtz, F. G. A. Van der Meche, M. P. Hazenberg, H. A. M. Achtereekte, and P. A. Van Doorn, “Serum anti-GQ(1b) IgG antibodies recognize surface epitopes on Campylobacter jejuni from patients with Miller Fisher syndrome,” Annals of Neurology, vol. 37, no. 2, pp. 260–264, 1995. View at Publisher · View at Google Scholar · View at Scopus
  21. A. Chiba, S. Kusunoki, T. Shimizu, and I. Kanazawa, “Serum IgG antibody to ganglioside GQ1b is a possible marker of Miller Fisher syndrome,” Annals of Neurology, vol. 31, no. 6, pp. 677–679, 1992. View at Publisher · View at Google Scholar · View at Scopus
  22. M. Ito, S. Kuwabara, M. Odaka et al., “Bickerstaff's brainstem encephalitis and Fisher syndrome form a continuous spectrum: Clinical analysis of 581 cases,” Journal of Neurology, vol. 255, no. 5, pp. 674–682, 2008. View at Publisher · View at Google Scholar · View at Scopus
  23. H. J. Willison and J. Veitch, “Immunoglobulin subclass distribution and binding characteristics of anti-GQ1b antibodies in Miller Fisher syndrome,” Journal of Neuroimmunology, vol. 50, no. 2, pp. 159–165, 1994. View at Publisher · View at Google Scholar · View at Scopus
  24. K. Mizoguchi, A. Hase, T. Obi et al., “Two species of antiganglioside antibodies in a patient with a pharyngeal-cervical-brachial variant of Guillain-Barre syndrome,” Journal of Neurology Neurosurgery and Psychiatry, vol. 57, no. 9, pp. 1121–1123, 1994. View at Scopus
  25. C. P. O'Leary, J. Veitch, W. F. Durward, A. M. Thomas, J. H. Rees, and H. J. Willison, “Acute oropharyngeal palsy is associated with antibodies to GQ1b and GT1a gangliosides,” Journal of Neurology Neurosurgery and Psychiatry, vol. 61, no. 6, pp. 649–651, 1996. View at Scopus
  26. K. Kashihara, Y. Shiro, M. Koga, and N. Yuki, “IgG anti-GT1a antibodies which do not cross react with GQ1b ganglioside in a pharyngeal-cervical-brachial variant of Guillain-Barre syndrome,” Journal of Neurology Neurosurgery and Psychiatry, vol. 65, no. 5, p. 799, 1998. View at Scopus
  27. Y. L. Lo, “Clinical and immunological spectrum of the Miller Fisher syndrome,” Muscle and Nerve, vol. 36, no. 5, pp. 615–627, 2007. View at Publisher · View at Google Scholar · View at Scopus
  28. M. Mori, T. Takeshima, N. Yuki, and K. Nakashima, “A case of anti-GQ1b-positive atypical Fisher syndrome with internal ophthalmoplegia but without external ophthalmoplegia,” Clinical Neurology, vol. 40, no. 9, pp. 887–890, 2000. View at Scopus
  29. H. Goldberg-Stern, E. Melamed, and N. Gadoth, “Abnormal evoked potentials in Miller-Fisher syndrome: further evidence of combined peripheral and central demyelination,” Journal of Neurology Neurosurgery and Psychiatry, vol. 57, no. 4, p. 506, 1994. View at Scopus
  30. V. Wong, “A neurophysiological study in children with Miller Fisher Syndrome and Guillain-Barre syndrome,” Brain and Development, vol. 19, no. 3, pp. 197–204, 1997. View at Publisher · View at Google Scholar · View at Scopus
  31. N. Yuki, K. Wakabayashi, M. Yamada, and K. Seki, “Overlap of Guillain-Barre syndrome and Bickerstaff's brainstem encephalitis,” Journal of the Neurological Sciences, vol. 145, no. 1, pp. 119–121, 1997. View at Publisher · View at Google Scholar · View at Scopus
  32. M. Kikuchi, Y. Tagawa, H. Iwamoto, H. Hoshino, and N. Yuki, “Bickerstaff's brainstem encephalitis associated with IgG anti-GQ1b antibody subsequent to Mycoplasma pneumoniae infection: favorable response to immunoadsorption therapy,” Journal of Child Neurology, vol. 12, no. 6, pp. 403–405, 1997. View at Scopus
  33. J. H. Yeh, W. H. Chen, J. R. Chen, and H. C. Chiu, “Miller fisher syndrome with central involvement: successful treatment with plasmapheresis,” Therapeutic Apheresis, vol. 3, no. 1, pp. 69–71, 1999. View at Publisher · View at Google Scholar · View at Scopus
  34. A. Chiba, S. Kusunoki, H. Obata, R. Machinami, and I. Kanazawa, “Serum anti-GQ(1b) IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain-Barre syndrome: clinical and immunohistochemical studies,” Neurology, vol. 43, no. 10, pp. 1911–1917, 1993. View at Scopus
  35. A. Chiba, S. Kusunoki, S. Kuwata, T. Juji, Y. Shibata, and I. Kanazawa, “HLA and anti-GQ1b IgG antibody in Miller Fisher syndrome and Guillain- Barre syndrome,” Journal of Neuroimmunology, vol. 61, no. 1, pp. 85–88, 1995. View at Publisher · View at Google Scholar · View at Scopus
  36. A. Chiba, S. Kusunoki, H. Obata, R. Machinami, and I. Kanazawa, “Ganglioside composition of the human cranial nerves, with special reference to pathophysiology of Miller Fisher syndrome,” Brain Research, vol. 745, no. 1-2, pp. 32–36, 1997. View at Publisher · View at Google Scholar · View at Scopus
  37. K. Paparounas, G. M. O'Hanlon, C. P. O'Leary, E. G. Rowan, and H. J. Willison, “Anti-ganglioside antibodies can bind peripheral nerve nodes of Ranvier and activate the complement cascade without inducing acute conduction block in vitro,” Brain, vol. 122, no. 5, pp. 807–816, 1999. View at Publisher · View at Google Scholar · View at Scopus
  38. M. Roberts, H. Willison, A. Vincent, and J. Newsom-Davis, “Serum factor in Miller-Fisher variant of Guillain-Barre syndrome and neurotransmitter release,” Lancet, vol. 343, no. 8895, pp. 454–455, 1994. View at Publisher · View at Google Scholar · View at Scopus
  39. H. J. Willison and J. J. Plomp, “Anti-ganglioside antibodies and the presynaptic motor nerve terminal,” Annals of the New York Academy of Sciences, vol. 1132, pp. 114–123, 2008. View at Publisher · View at Google Scholar · View at Scopus
  40. D. J. Lange, T. DeAngelis, and M. A. Sivak, “Single-fiber electromyography shows terminal axon dysfunction in Miller Fisher syndrome: a case report,” Muscle and Nerve, vol. 34, no. 2, pp. 232–234, 2006. View at Publisher · View at Google Scholar · View at Scopus
  41. S. Kuwabara, M. Asahina, M. Nakajima et al., “Special sensory ataxia in Miller Fisher syndrome detected by postural body sway analysis,” Annals of Neurology, vol. 45, no. 4, pp. 533–536, 1999.
  42. H. J. Willison, G. M. O'Hanlon, G. Paterson et al., “A somatically mutated human antiganglioside IgM antibody that induces experimental neuropathy in mice is encoded by the variable region heavy chain gene, V1-18,” Journal of Clinical Investigation, vol. 97, no. 5, pp. 1155–1164, 1996. View at Scopus
  43. S. Kusunoki, A. Chiba, and I. Kanazawa, “Anti-GQ1b IgG antibody is associated with ataxia as well as ophthalmoplegia,” Muscle & Nerve, vol. 22, no. 8, pp. 1071–1074, 1999.
  44. A. J. Kornberg, A. Pestronk, G. M. Blume, G. Lopate, J. Yue, and A. Hahn, “Selective staining of the cerebellar molecular layer by serum IgG in Miller-Fisher and related syndromes,” Neurology, vol. 47, no. 5, pp. 1317–1320, 1996. View at Scopus
  45. A. Inoue, C. S. Koh, and T. Iwahashi, “Detection of serum anticerebellar antibodies in patients with Miller Fisher syndrome,” European Neurology, vol. 42, no. 4, pp. 230–234, 1999. View at Scopus
  46. R. Bingisser, R. Speich, A. Fontana, J. Gmur, B. Vogel, and T. Landis, “Lupus erythematosus and Miller-Fisher syndrome,” Archives of Neurology, vol. 51, no. 8, pp. 828–830, 1994. View at Scopus
  47. D. C. Hess, E. Awad, H. Posas, K. D. Sethi, and R. J. Adams, “Miller Fisher syndrome in systemic lupus erythematosus,” Journal of Rheumatology, vol. 17, no. 11, pp. 1520–1522, 1990. View at Scopus
  48. A. Polizzi, M. Ruggieri, I. Vecchio, S. Genovese, L. Rampello, and R. Raffaele, “Autoimmune thyroiditis and acquired demyelinating polyradiculoneuropathy,” Clinical Neurology and Neurosurgery, vol. 103, no. 3, pp. 151–154, 2001. View at Publisher · View at Google Scholar · View at Scopus
  49. S. S. Desai, E. Allen, and A. Deodhar, “Miller Fisher syndrome in adult onset Still's disease: case report and review of the literature of other neurological manifestations,” Rheumatology, vol. 41, no. 2, pp. 216–222, 2002. View at Scopus
  50. M. Guarino, A. Stracciari, F. Cirignotta, R. D'Alessandro, and P. Pazzaglia, “Neoplastic meningitis presenting with ophthalmoplegia, ataxia, and areflexia (Miller-Fisher syndrome),” Archives of Neurology, vol. 52, no. 5, pp. 443–444, 1995. View at Scopus
  51. Y. Nakatsuji, S. Sadahiro, S. Watanabe et al., “Leptomeningeal signet-ring cell carcinomatosis presenting with ophthalmoplegia, areflexia and ataxia,” Clinical Neuropathology, vol. 20, no. 6, pp. 272–275, 2001. View at Scopus
  52. T. Csépány, J. Boczán, M. T. Magyar et al., “Miller Fisher syndrome: a presenting clinical manifestation of lung cancer in a previously apparently healthy individual,” Journal of Neurology, vol. 251, no. 7, pp. 898–900, 2004. View at Scopus
  53. E. Rubio-Nazabal, J. Marey-Lopez, J. P. Torres-Carrete, P. Alvarez-Perez, and P. R. Del Corral, “Miller-Fisher syndrome and Hodgkin's disease,” Journal of Neurology Neurosurgery and Psychiatry, vol. 73, no. 3, p. 344, 2002. View at Publisher · View at Google Scholar · View at Scopus
  54. L. De Toni, S. Marconi, E. Nardelli et al., “Gangliosides act as onconeural antigens in paraneoplastic neuropathies,” Journal of Neuroimmunology, vol. 156, no. 1-2, pp. 178–187, 2004. View at Publisher · View at Google Scholar · View at Scopus
  55. S. Gentile, M. Messina, I. Rainero, R. Lo Giudice, P. De Martino, and L. Pinessi, “Miller Fisher syndrome associated with Burkitt's lymphoma,” European Journal of Neurology, vol. 13, no. 4, p. 430, 2006. View at Publisher · View at Google Scholar · View at Scopus
  56. Z. Aki, O. Aksoy, G. Sucak, R. Kuruoğlu, and M. Yağci, “Miller-Fisher syndrome associated with chronic lymphocytic leukemia,” Neurology India, vol. 56, no. 2, pp. 198–200, 2008. View at Publisher · View at Google Scholar · View at Scopus
  57. A. A. Tahrani, S. Sharma, S. Rangan, and A. F. Macleod, “A patient with worsening mobility: a diagnostic challenge,” European Journal of Internal Medicine, vol. 19, no. 4, pp. 292–294, 2008. View at Publisher · View at Google Scholar · View at Scopus