Emphasis on the Optimal Functional Recovery Through a Structured Inpatient Rehabilitation Program Along With a Home Exercise Regime in an Individual With Miller-Fisher Syndrome: A Case Report

Abstract

Guillain-Barre syndrome (GBS) is a rare inflammatory demyelinating polyradiculoneuropathy characterized by motor impairment, progressive, ascending, symmetrical flaccid limb paralysis, areflexia or hyporeflexia, and with or without cranial nerve involvement, which are the hallmark clinical indications of GBS, which can last over weeks to months. Miller-Fisher syndrome (MFS) is a post-infectious localized variant of GBS that includes ophthalmoplegia, ataxia, and areflexia, and is often associated with lower cranial and facial nerve involvement. In this case, a 22-year-old young man was taken to a hospital after 10 days with complaints of bilateral symmetrical upper extremity and lower extremity paralysis, with the legs being more afflicted than the arms. For the past six days, he had an episode of fever, slurred speech, bilateral eye drops, and swallowing difficulty. On examination, the patient was identified with MFS, a variant of GBS. On the first and last day of treatment, the patient's outcome measures were recorded on Manual Muscle Testing, Hughes (GBS disability score), and the Functional Independence Measure Scale. Treatment options have been shown to reduce challenges and improve patient outcomes and quality of life, all of which are important at this stage. This case study concluded with a rehabilitation program that helped the patient to enhance his strength, range of motion, functional mobility, postural control, balancing abilities, weight-bearing, and prevent secondary impairments.

Keywords: frenkel's; guillain-barre syndrome; hughes severity scale; miller-fisher syndrome; physical rehabilitation.

Figure 1. A graphical representation of manual muscle testing of upper limb

Figure 2. A graphical illustration of lower-limb manual muscle testing

Figure 3. The status of the patient on the first day of physical therapy

(A): Suggests the patient was bedridden and unable to initiate activities of daily living. (B): Patient was performing active exercises of the upper extremity.

Figure 4. Patient status after six weeks of physical therapy

(A): The patient was efficiently performing parallel bar activities. (B): After six weeks of the regimen, the patient was able to stand independently.