Akademik Veri Yönetim Sistemi
16th European Paediatric Neurology Society Congress, Munich, Almanya, 8 - 12 Temmuz 2025, ss.336, (Özet Bildiri)
Objectives Guillain-Barré syndrome (GBS) is an acute immune-mediated inflammatory polyneuropathy typically characterized by symmetric and ascending weakness. Miller Fisher syndrome (MFS) is a rare variant of GBS defined by the triad of external ophthalmoplegia, areflexia and ataxia. Approximately 85-90% of patients with MFS are positive for the anti-GQ1b IgG antibody. Methods In this study, we present a retrospective analysis of five pediatric cases diagnosed with MFS in our clinic. Results The male to female ratio among the children diagnosed with MFS was 4:1. The age range of the patients was from 3 years and 10 months to 10 years. All cases had a history of infection within the previous two weeks. Three patients had acute gastroenteritis and two had upper respiratory tract infections. Serum creatine kinase (CK) levels were measured in four patients, one of whom had elevated levels (CK=238). Anti-GQ1b antibodies were positive in 80% of patients. Case 1: A patient diagnosed with MISC after presenting with fever, fatigue and rash during a one-week course of antibiotics was treated with IVIg, steroids and aspirin. Three days after discharge, the patient developed double vision and headache; examination revealed bilateral restricted upward and outward gaze. Case 2: A patient presented with double vision and weakness one week after experiencing diarrhea and fever. The light reflex was absent, suggesting a second cranial nerve involvement. Subsequently, ataxia and ophthalmoparesis developed. The patient was treated with repeated IVIg and plasmapheresis and was discharged on day 21. Conclusions In MFS, diplopia is often the initial symptom, with ataxia and areflexia appearing at different times. Longitudinal assessment is crucial for diagnosis. Anti-GQ1b IgG antibodies have been reported in MFS, GBS, Bickerstaff brainstem encephalitis and patients with acute ophthalmoplegia. In cases where the classic MFS triad is absent but atypical features are present, measurement of ganglioside antibodies may aid diagnosis.