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Case Reports
. 2005 Jul;45(7):524-6.

[Acute divergence paralysis in the Miller Fisher syndrome]

[Article in Japanese]
Hiroaki Oguro  1 , Shuhei Yamaguchi, Satoshi Abe, Hirokazu Bokura, Shotai Kobayashi
Affiliations
  • PMID: 16119838
Case Reports

[Acute divergence paralysis in the Miller Fisher syndrome]

[Article in Japanese]
Hiroaki Oguro et al. Rinsho Shinkeigaku. 2005 Jul.

Abstract

We experienced a 53-year-old man diagnosed as Miller Fisher syndrome (MFS) associated with anti-GQ1b and anti-GT1a antibodies. He presented acute divergence paralysis, bulbar palsy, ascending hyperesthesia, areflexia and diminished vibration sense. External ophthalmoplegia and convergence paralysis were not seen, but he noticed double vision when looking at an object from the distance of more than 70 cm away on a day 10 of hospitalization. Hess chart test revealed an esotropic pattern, so the diagnosis of divergence palsy was made. Brain MRI was normal. Neurological deficits were treated with plasma exchange, resulting in favorable outcome. Divergence paralysis could be one of the clinical manifestations for MFS and might be due to nuclear or supranuclear damge of vergence-related neurons.

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