IVIG Administration Accelerate Recovery in Pediatric Miller

Fisher Syndromes:
A Case Report
By :
Rahmad Ramadhani
Nurul Hidayah
Ruslan Muhyi
Departement of Pediatrics Ulin General Hospital/Faculty of Medicine Lambung Mangkurat University, Banjarmasin, South Kalimantan,
Indonesia
BACKGROUNDS AND OBJECTIVES
BACKGROUNDS

• Miller Fisher Syndrome (MFS) is a subtype of OBJECTIVES

Guillain Barre Syndrome (GBS) and only
account about 5% of GBS case
To demonstrate favorable response of IVIg
• In adult study, Intravenous Immunoglobulin administration to the recovery of pediatric MFS
(IVIg) for MFS seem not to have influenced patient
patients' outcomes
• Recovery occurred after a mean time period of
10 weeks
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2. Arányi Z, Kovács T, Sipos I, Bereczki D. Miller Fisher syndrome: brief overview and update with a focus on electrophysiological findings. European journal of neurology.
2012 Jan;19(1):15-e3.
3. Mori M, Kuwabara S, Fukutake T, Hattori T. Intravenous immunoglobulin therapy for Miller Fisher syndrome. Neurology. 2007 Apr 3;68(14):1144-6.
 CASE PRESENTATION
SYMPTOMS
A 12 years old boy with :
• Dysphagia, Blurred vision, Ataxia
since 3 weeks before.
• Unable to stand by himself on
admission
PHYSICAL EXAMINATION
• Bilateral ptosis
• Nervus VII and IX paresis
• Areflexia
• Decreased motoric strength of
lower extremity
CEREBROSPINAL FLUID TREATMENTS
EXAMINATION • IVIg 400 mg/KgBW/day for 5
• Cytoalbumin dissociation consecutive days at 7th days of
treatment
ELECTROPHYSIOLOGICAL
EXAMINATION FOLLOW UP
• Suggestive acute motor and • On the 4th day of IVIg
sensory axonal neuropathy administration clinically condition
(AMSAN). was improved.
• 6 weeks from 1st symptom he was
able to carry out his usual
activities.
CONCLUSION

IVIg administration may accelerate

recovery in pediatric Miller Fisher
Syndrome, and need further investigation.
THANK YOU