Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination

Summary: Guillain-Barre Syndrome is an immune-mediated demyelinating disorder. Miller-Fisher Syndrome is an uncommon subtype of GBS. It is characterized by findings of ophthalmoplegia, ataxia, and areflexia. Here we present the case of Miller-Fisher Syndrome following an episode of typhoidal diarrh...

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Main Authors: Tayyaba Binte Saleem, Muhammad Ibrahim, Faizan Fazal, Mohammad Ebad Ur Rehman, Ali Ahmad Ijaz, Humera Nasim
Format: Article
Language:English
Published: Rawalpindi Medical University 2023-12-01
Series:Journal of Rawalpindi Medical College
Online Access:https://www.journalrmc.com/index.php/JRMC/article/view/2289
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author Tayyaba Binte Saleem
Muhammad Ibrahim
Faizan Fazal
Mohammad Ebad Ur Rehman
Ali Ahmad Ijaz
Humera Nasim
author_facet Tayyaba Binte Saleem
Muhammad Ibrahim
Faizan Fazal
Mohammad Ebad Ur Rehman
Ali Ahmad Ijaz
Humera Nasim
author_sort Tayyaba Binte Saleem
collection DOAJ
description Summary: Guillain-Barre Syndrome is an immune-mediated demyelinating disorder. Miller-Fisher Syndrome is an uncommon subtype of GBS. It is characterized by findings of ophthalmoplegia, ataxia, and areflexia. Here we present the case of Miller-Fisher Syndrome following an episode of typhoidal diarrhea. The presentation was of rapidly progressing weakness beginning in the lower extremity with diplopia. Examination revealed diminished reflexes. CSF testing revealed albuminocytologic dissociation which was later supported by neurophysiological testing. The patient was treated with intravenous immunoglobulins (IVIG). We conclude that Miller-Fisher syndrome should be considered in the diagnostic workup of patients presenting with new sensorimotor deficits following diarrheal illnesses and/or COVID-19 mRNA vaccination. Early recognition is essential given the propensity of GBS to cause life-threatening respiratory failure and prompt IVIG administration is associated with a better prognosis. Keywords: Enteric Fever, Miller-Fisher Syndrome, COVID-19, Vaccination
format Article
id doaj-art-6355691f53364563b1bb673a7b501b4c
institution Kabale University
issn 1683-3562
1683-3570
language English
publishDate 2023-12-01
publisher Rawalpindi Medical University
record_format Article
series Journal of Rawalpindi Medical College
spelling doaj-art-6355691f53364563b1bb673a7b501b4c2025-02-06T08:40:37ZengRawalpindi Medical UniversityJournal of Rawalpindi Medical College1683-35621683-35702023-12-0127410.37939/jrmc.v27i4.2289Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 VaccinationTayyaba Binte SaleemMuhammad IbrahimFaizan Fazal0Mohammad Ebad Ur RehmanAli Ahmad IjazHumera NasimRawalpindi Medical University Summary: Guillain-Barre Syndrome is an immune-mediated demyelinating disorder. Miller-Fisher Syndrome is an uncommon subtype of GBS. It is characterized by findings of ophthalmoplegia, ataxia, and areflexia. Here we present the case of Miller-Fisher Syndrome following an episode of typhoidal diarrhea. The presentation was of rapidly progressing weakness beginning in the lower extremity with diplopia. Examination revealed diminished reflexes. CSF testing revealed albuminocytologic dissociation which was later supported by neurophysiological testing. The patient was treated with intravenous immunoglobulins (IVIG). We conclude that Miller-Fisher syndrome should be considered in the diagnostic workup of patients presenting with new sensorimotor deficits following diarrheal illnesses and/or COVID-19 mRNA vaccination. Early recognition is essential given the propensity of GBS to cause life-threatening respiratory failure and prompt IVIG administration is associated with a better prognosis. Keywords: Enteric Fever, Miller-Fisher Syndrome, COVID-19, Vaccination https://www.journalrmc.com/index.php/JRMC/article/view/2289
spellingShingle Tayyaba Binte Saleem
Muhammad Ibrahim
Faizan Fazal
Mohammad Ebad Ur Rehman
Ali Ahmad Ijaz
Humera Nasim
Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination
Journal of Rawalpindi Medical College
title Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination
title_full Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination
title_fullStr Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination
title_full_unstemmed Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination
title_short Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination
title_sort enteric fever as an antecedent to development of miller fisher syndrome and possible role of covid 19 vaccination
url https://www.journalrmc.com/index.php/JRMC/article/view/2289
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