MILLER-FISHER-SYNDROME IN A 7-YEAR-OLD

Miller-Fisher syndrome is a separate nosologic entity that is uncommon in children (less than 1% of all Guillain-Barre cases). A seven-year- old with an unremarkable medical history was admitted for a two-month history of Miller-Fisher syndrome with cerebellar ataxia and slightly impaired coordination. Electrophysiologic data were consistent with a primarily axonal sensory neuropathy affecting all four limbs, accompan ied with some degree of radicular involvement. A protein level of 0.56 gn was the only cerebrospinal fluid abnormality. Findings were normal or negative from laboratory tests and serologic tests for bacteria. C omputed tomography of the brain with thin slices through the posterior fossa was normal. The outcome was favorable under methylprednisolone therapy. At last follow-up three years later, the only abnormality was absence of the deep tendon reflexes. The low incidence of Miller-Fish er syndrome in children deserves to be emphasized. The cerebellar mani festations and favorable course under methylprednisolone therapy are d iscussed.