Miller Fisher Syndrome Triggered by Infections: A Review of the Literature and a Case Report

J Child Neurol. 2021 Feb 11:883073821988428. doi: 10.1177/0883073821988428. Online ahead of print.

Abstract

Aim: We reported a case of Miller Fisher syndrome following a breakthrough varicella zoster virus infection in an otherwise healthy 6-year-old male. The objective of this review was to summarize the infectious etiologic agents known to trigger Miller Fisher syndrome.

Methods: Review of the literature on infections associated with Miller Fisher syndrome.

Results: We identified 762 studies after duplicates were removed. Titles, abstracts, and full texts were screened. Finally, 37 studies were included in qualitative synthesis after citations and reference list were checked. The age range of cases reported was 0-78 years, and male sex was predominant in studies where these parameters were reported. The most common causative agent was Campylobacter jejuni followed by Haemophilus influenzae.

Conclusions: Our review highlights the importance of recognizing the infections triggering Miller Fisher syndrome. We also present a unique case of Miller Fisher syndrome associated with breakthrough varicella zoster virus infection. Preventive policies may consider population immunization for certain causative agents.

Keywords: Miller Fisher syndrome; infectious etiologic agents; varicella zoster virus.