MR imaging findings of spinal posterior column involvement in a case of Miller Fisher syndrome

AJNR Am J Neuroradiol. 2004 Apr;25(4):645-8.

Abstract

The site of lesions causing ataxia in Miller Fisher syndrome (MFS) remains in dispute. A 43-year-old man manifested rapidly progressive left-sided ptosis, bilateral abducens palsy, areflexia, and severe ataxia. Initial MR imaging showed confined lesions of the cauda equina with gadolinium enhancement. A diagnosis of MFS was made, and the patient underwent immunotherapy. His ophthalmoplegia disappeared, but other symptoms remained. Five months after onset, MR imaging disclosed lesions confined to the spinal posterior column, which were considered to result from involvement of posterior nerve roots of the cauda equina and to be responsible for his remaining severe ataxia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cauda Equina* / pathology
  • Cervical Vertebrae / pathology
  • Diagnosis, Differential
  • Disability Evaluation
  • Functional Laterality
  • Gait Ataxia / diagnosis*
  • Gait Ataxia / therapy
  • Humans
  • Immunization, Passive
  • Immunoglobulin gamma-Chains / therapeutic use
  • Magnetic Resonance Imaging*
  • Male
  • Miller Fisher Syndrome / diagnosis*
  • Miller Fisher Syndrome / therapy
  • Neurologic Examination
  • Polyradiculopathy / diagnosis*
  • Polyradiculopathy / etiology
  • Polyradiculopathy / therapy
  • Spinal Cord / pathology
  • Spinal Nerve Roots* / pathology
  • Thoracic Vertebrae / pathology
  • Treatment Outcome

Substances

  • Immunoglobulin gamma-Chains