Miller Fisherov syndróm (MFS) je lokalizovaný variant Guillainovho-Barrého syndrómu (GBS). Klinicky je charakterizovaný triádou príznakov – oftalmoplégia, areflexia a ataxia. U pacientov s MFS sa zisťujú antigangliozidové protilátky anti-GQ1b triedy IgG. Antigénnymi terčmi týchto autoprotilátok sú membrány presynaptických zakončení nervovosvalového spojenia a Schwannove bunky. V práci referujeme o 1 pacientovi s lokalizovanou formou MFS a o 2 pacientoch s prechodnou formou medzi MFS a GBS. Článok je zameraný na patogenézu, klinické prejavy, diagnostické kritériá, diferenciálnu diagnostiku a možnosti liečby Miller Fisherovho syndrómu. V liečbe MFS je účinná plazmaferéza alebo terapia intravenóznym imunoglobulínom, najmä u pacientov s prechodnou formou medzi MFS a GBS.

Miller Fisher syndrome (MFS) is a localized variant of Guillain-Barré syndrome (GBS), characterized by ophthalmoplegia, areflexia and ataxia. Anti-GQ1b IgG antibodies are present in MFS and are believed to be pathogenic. Presynaptic neural membranes and perisynaptic Schwann cells are targets for anti-GQ1b antibody attack. We report one patient with localized MFS and two patients with overlapping form of MFS and GBS. This article focuses on pathogenesis, clinical spectrum, diagnostic criteria, differential diagnosis and treatment of MFS. Both plasmapheresis and intravenous immunoglobulin are effective first-line therapies, especially in cases of MFS with overlapping GBS.

Miller fisher syndrome – three case reports, diagnosis and treatment