MILLER-FISHER SYNDROME MIMICKING STROKE IN IMMUNOSUPPRESSED PATIENT WITH RHEUMATOID-ARTHRITIS RESPONDING TO PLASMA-EXCHANGE

A patient with rheumatoid arthritis on immunosuppressive therapy was a dmitted to hospital with the sudden onset of diplopia and ataxia. Beca use of the history, a stroke was thought most likely. However, as he p rogressed a diagnosis of the Miller Fisher syndrome was established. H e responded to plasma exchange. This presentation is highly unusual an d has not previously been described. In addition, the possibility of i mmune dysregulation setting the stage for the development of this synd rome is discussed. The role of plasma exchange for this condition is a lso reviewed.