Abstract
SARS-CoV-2 infections are increasingly associated with neurological complications, including immune-mediated neuropathies. Miller-Fisher syndrome is a rare variant of Guillain-Barré syndrome characterised by the triad of ataxia, ophthalmoplegia and areflexia. Here we present a case of Miller-Fisher syndrome following COVID-19 infection. The clinical presentation was a short history of a rapidly-progressive peripheral sensorimotor neuropathy with bulbar dysfunction and facial weakness following mild COVID infection. Examination revealed global areflexia and a broad-based ataxic gait. CSF analysis revealed albuminocytological dissociation and neurophysiological testing later supported the diagnosis. The patient required high flow nasal oxygen therapy for respiratory dysfunction in a level 2 care setting and received immunological treatment with intravenous immunoglobulins. We conclude that Miller-Fisher syndrome needs to be considered in patients presenting with new sensorimotor dysfunction following SARS-COV-2 infection. Early recognition is key given the propensity to cause life-threatening respiratory failure, and early administration of immunological treatment is associated with improved prognosis.
Keywords: Artificial respiration; Intensive care unit; Intravenous immunoglobulins; Miller–Fisher syndrome; SARS-CoV-2.
【저자키워드】 intensive care unit, SARS-CoV-2., Artificial respiration, Intravenous immunoglobulins, Miller–Fisher syndrome, 【초록키워드】 Treatment, SARS-CoV-2, therapy, Respiratory failure, Prognosis, SARS-COV-2 infection, immunoglobulins, variant, Infection, intensive care unit, Diagnosis, oxygen, COVID, COVID-19 infection, artificial, Patient, Oxygen therapy, Mild, Neurological complications, respiratory, Care, SARS-CoV-2 infections, Guillain-barrè syndrome, Immune-mediated, Artificial respiration, Neuropathy, intravenous, Ataxia, level 2, dysfunction, ataxic gait, examination, syndrome, life-threatening, weakness, early administration, Fisher syndrome, ophthalmoplegia, triad, immunological, areflexia, CSF analysis, required, supported, presenting, increasingly, ataxic, facial, nasal oxygen, 【제목키워드】 Case report, syndrome,