Miller Fisher Syndrome (MFS) is a disease of the nerves. It is a form of Guillain-Barre Syndrome (GBS) and named after a well-known neurologist, Dr. C. Miller Fisher.
Miller Fisher Syndrome (MFS) is characterized by three conditions:
- Weakness of the eye muscles also known as ophthalmoplegia. Double vision is usually the first sign of the weakened eye muscles.
- Difficulty walking or controlling your muscle also known as ataxia.
- Loss of your reflexes also known as areflexia. So when your doctor hits your knee with the little hammer your leg will not move because your reflex would be absent.
These three conditions progress over about a week. Someone with Miller Fisher Syndrome will develop double vision followed by facial weakness that causes drooping of the eyes and skin on the face.
What causes Miller Fisher Syndrome?
Our body is an amazing instrument that is connected to the brain by our nerves. The nerves control how we move our arms and legs and even when we breathe. You can think about our nerves like little wires with protective coating. The coating allows the signals from the brain to travel along the nerve to the muscle. The nerves in people with Miller Fisher Syndrome, just like in GBS, are under attack by the body’s own immune system.
The immune system attacks the protective covering around the nerves (myelin sheath). When the protective covering is damaged the signal the brain sends to the muscle becomes lost or damaged. In the case of people with Miller Fisher Syndrome the nerves that control the muscles in the face and eyes are damaged by the body’s own immune syndrome causing the weak eye muscles.
How is Miller Fisher Syndrome Diagnosed?
Diagnosis of Miller Fisher Syndrome is done with a combination of clinical signs and tests.
- Poor coordination and balance
- No reflexes
- Problems with pupils in the eyes
- Eyelid drooping also known as ptosis
- Trouble chewing, speaking, swallowing also known as Bulbar palsy
A neurologist seeing patient with the signs and symptoms of Miller Fisher Syndrome would likely order a nerve conduction test. A nerve conduction test (EMG or NCS) would be performed to check whether or not the protective covering surrounding the nerves are damaged. A doctor may also order magnetic resonance imaging (MRI) and lumbar tap test (spinal tap).