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Article ; Online: Miller-Fisher syndrome after SARS-CoV-2 infection.

Reyes-Bueno, J A / García-Trujillo, L / Urbaneja, P / Ciano-Petersen, N L / Postigo-Pozo, M J / Martínez-Tomás, C / Serrano-Castro, P J

European journal of neurology

2020 Volume 27, Issue 9, Page(s) 1759–1761

Abstract: Introduction: On March 11th, 2020, the WHO declared the SARS-Cov-2 pandemic. Syndromes have been ... We present a 51 years old female diagnosed with MFS two weeks after COVID-19. RTPCR to SARS-CoV-2 was ... neurological syndromes suggests that this is probably not an infrequent complication in the subacute stage ...

Abstract	Introduction: On March 11th, 2020, the WHO declared the SARS-Cov-2 pandemic. Syndromes have been detected in relation to COVID-19 such as encephalitis, acute necrotizing hemorrhagic encephalopathy and cerebrovascular complications. There are also cases of peripheral nervous system involvement. Methods: Our case would be the 3rd patient with MFS associated with COVID-19 as far as we know. Results: We present a 51 years old female diagnosed with MFS two weeks after COVID-19. RTPCR to SARS-CoV-2 was negative but IgG was positive. Conclusion: Most of the cases were mild or moderate with typical signs and symptoms. All were treated with IV immunoglobulin with good response in most cases. Despite the short evolution time of the cases surviving the current pandemic, the description of cases of post-infectious neurological syndromes suggests that this is probably not an infrequent complication in the subacute stage of Covid-19 disease.
MeSH term(s)	COVID-19/complications ; Female ; Humans ; Immunoglobulins, Intravenous ; Middle Aged ; Miller Fisher Syndrome/drug therapy ; Miller Fisher Syndrome/etiology ; Treatment Outcome
Chemical Substances	Immunoglobulins, Intravenous
Keywords	covid19
Language	English
Publishing date	2020-06-30
Publishing country	England
Document type	Case Reports
ZDB-ID	1280785-0
ISSN	1468-1331 ; 1351-5101 ; 1471-0552
ISSN (online)	1468-1331
ISSN	1351-5101 ; 1471-0552
DOI	10.1111/ene.14383
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Article ; Online: Miller‐Fisher syndrome after SARS‐CoV‐2 infection

Reyes‐Bueno, J. A. / García‐Trujillo, L. / Urbaneja, P. / Ciano‐Petersen, N. L. / Postigo‐Pozo, M. J. / Martínez‐Tomás, C. / Serrano‐Castro, P. J.

European Journal of Neurology

2020 Volume 27, Issue 9, Page(s) 1759–1761

Keywords	Neurology ; Clinical Neurology ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	1280785-0
ISSN	1468-1331 ; 1351-5101 ; 1471-0552
ISSN (online)	1468-1331
ISSN	1351-5101 ; 1471-0552
DOI	10.1111/ene.14383
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Article: Miller-Fisher syndrome after SARS-CoV-2 infection

Reyes-Bueno, José Antonio / García-Trujillo, Lucía / Urbaneja, Patricia / Ciano-Petersen, Nicolás Lundahl / Postigo-Pozo, María José / Martínez-Tomás, César / Serrano-Castro, Pedro J

Eur. j. neurol

Abstract: On March 11th, 2020, the WHO declared the SARS-Cov-2 pandemic. Syndromes have been detected ... two weeks after COVID-19. RT-PCR to SARS-CoV-2 was negative but IgG was positive. Most of the cases ... pandemic, the description of cases of post-infectious neurological syndromes suggests that this is probably ...

Abstract	On March 11th, 2020, the WHO declared the SARS-Cov-2 pandemic. Syndromes have been detected in relation to COVID-19 such as encephalitis, acute necrotizing hemorrhagic encephalopathy and cerebrovascular complications. There are also cases of peripheral nervous system involvement. Our case would be the 3rd patient with MFS associated with COVID-19 as far as we know. We present a 51 years old female diagnosed with MFS two weeks after COVID-19. RT-PCR to SARS-CoV-2 was negative but IgG was positive. Most of the cases were mild or moderate with typical signs and symptoms. All were treated with IV immunoglobulin with good response in most cases. Despite the short evolution time of the cases surviving the current pandemic, the description of cases of post-infectious neurological syndromes suggests that this is probably not an infrequent complication in the subacute stage of Covid-19 disease.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #546636
Database	COVID19

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Article ; Online: A case report of thrombocytopenic COVID-19 and Miller-Fisher syndrome on a concurrent chronic immune neuropathy.

Blackbourn, Lisle / Hamid, Umair / Tokala, Janaki / Blume, Gregory

Medicine

2024 Volume 103, Issue 21, Page(s) e38304

Abstract: Rationale: Miller-Fisher syndrome (MFS) is a rare subtype of Guillain-Barre syndrome with classic ... effect of COVID-19 on the various Guillain-Barre syndrome subtypes is unknown, although it clearly can be ... physical therapy.: Outcomes: The patient significantly improved after initial treatment.: Lessons: The full ...

Abstract	Rationale: Miller-Fisher syndrome (MFS) is a rare subtype of Guillain-Barre syndrome with classic features of ataxia, areflexia, and ophthalmoplegia that can be caused by a preceding infection including COVID-19. We present a current, asymptomatic thrombocytopenic COVID-19 infection as a cause of MFS in a 60-year-old male with a concurrent chronic immune neuropathy. Patient concerns: A 60-year-old male presenting with acute symptoms of MFS including ataxia, areflexia, and ophthalmoplegia on a chronic immune neuropathy for at least 1 year and concurrent asymptomatic COVID-19 positive infection. Diagnosis: MFS suspected secondary to a current thrombocytopenic COVID-19 infection. Interventions: Five days of intravenous immune globulin with continued monthly intravenous immune globulin as an outpatient, follow-up long-term in a neuromuscular clinic, electromyography as an outpatient, and continued physical therapy. Outcomes: The patient significantly improved after initial treatment. Lessons: The full effect of COVID-19 on the various Guillain-Barre syndrome subtypes is unknown, although it clearly can be a cause of the various variants including being caused by a current, asymptomatic infection.
MeSH term(s)	Humans ; Miller Fisher Syndrome/diagnosis ; Miller Fisher Syndrome/immunology ; Male ; COVID-19/complications ; COVID-19/immunology ; Middle Aged ; Immunoglobulins, Intravenous/therapeutic use ; SARS-CoV-2 ; Thrombocytopenia
Chemical Substances	Immunoglobulins, Intravenous
Language	English
Publishing date	2024-05-24
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000038304
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Article ; Online: Retrospective analysis of COVID-19 patients with Guillain-Barre, Miller-Fisher, and opsoclonus-myoclonus-ataxia syndromes-a case series.

Olbert, Elisabeth / Alhani, Naela / Struhal, Walter

Wiener medizinische Wochenschrift (1946)

2023 Volume 174, Issue 1-2, Page(s) 30–34

Abstract: ... two patients, both with disease onset concurrent with SARS-COV‑2 infection, recovered swiftly ... such as Guillain-Barre syndrome (GBS), Miller-Fisher syndrome (MFS), and opsoclonus-myoclonus-ataxia syndrome (OMAS). While GBS ... Background: In accordance with the rising number of SARS-CoV‑2 infections, reports of neurological ...

Abstract	Background: In accordance with the rising number of SARS-CoV‑2 infections, reports of neurological complications have also increased. They include cerebrovascular diseases but also immunological diseases such as Guillain-Barre syndrome (GBS), Miller-Fisher syndrome (MFS), and opsoclonus-myoclonus-ataxia syndrome (OMAS). While GBS and MFS are typical postinfectious complications, OMAS has only recently been described in the context of COVID-19. GBS, MFS, and OMAS can occur as para- and postinfectious, with different underlying pathomechanisms depending on the time of neurological symptom onset. The study aimed to describe clinical features, time between infection and onset of neurological symptoms, and outcome for these diseases. Methods: All COVID-19 patients treated in the neurological ward between January 2020 and December 2022 were screened for GBS, MFS, and OMAS. The clinical features of all patients, with a particular focus on the time of onset of neurological symptoms, were analyzed. Results: This case series included 12 patients (7 GBS, 2 MFS, 3 OMAS). All GBS and one MFS patient received immunomodulatory treatment. Three patients (2 GBS, 1 OMAS) had a severe COVID-19 infection and received mechanical ventilation. In patients with OMAS, only one patient received treatment with intravenous immunoglobulin and cortisone. The remaining two patients, both with disease onset concurrent with SARS-COV‑2 infection, recovered swiftly without treatment. In all subgroups, patients with concurrent onset of neurological symptoms and COVID-19 infection showed a trend toward shorter disease duration. Conclusion: All patient groups displayed a shorter disease duration if the onset of neurological symptoms occurred shortly after the COVID-19 diagnosis. In particular, both the OMAS patients with symptom onset concurrent with COVID-19 showed only abortive symptoms followed by a swift recovery. This observation would suggest different pathomechanisms for immune-mediated diseases depending on the time of onset after an infection.
MeSH term(s)	Humans ; Guillain-Barre Syndrome/diagnosis ; Guillain-Barre Syndrome/therapy ; Guillain-Barre Syndrome/complications ; Retrospective Studies ; COVID-19 Testing ; Myoclonus/complications ; Ocular Motility Disorders/complications ; COVID-19/complications ; SARS-CoV-2 ; Miller Fisher Syndrome/diagnosis ; Miller Fisher Syndrome/therapy ; Miller Fisher Syndrome/complications ; Ataxia/complications
Language	English
Publishing date	2023-07-31
Publishing country	Austria
Document type	Journal Article
ZDB-ID	123613-1
ISSN	1563-258X ; 0254-7945 ; 0043-5341
ISSN (online)	1563-258X
ISSN	0254-7945 ; 0043-5341
DOI	10.1007/s10354-023-01018-4
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Article ; Online: Miller Fischer syndrome after COVID-19 infection and vaccine: a systematic review.

Neophytou, Panayiota / Artemiadis, Artemios / Hadjigeorgiou, Georgios M / Zis, Panagiotis

Acta neurologica Belgica

2023 Volume 123, Issue 5, Page(s) 1693–1701

Abstract: ... SARS-CoV-2 virus (Severe Acute Respiratory Syndrome CoronaVirus-2). The virus mainly causes respiratory ... of this study was to systematically review Miller fisher syndrome (MFS) published cases, in the context of COVID ... cardiac arrythmia.: Conclusions: MFS after COVID-19 infection/vaccination was found to have the typical ...

Abstract	Background: COVID-19 (CoranaVirus disease 2019) is an ongoing infectious disease caused by the RNA SARS-CoV-2 virus (Severe Acute Respiratory Syndrome CoronaVirus-2). The virus mainly causes respiratory symptoms, but neurological symptoms have also been reported to be part of the clinical manifestations of the disease. The aim of this study was to systematically review Miller fisher syndrome (MFS) published cases, in the context of COVID-19 infection or vaccination. Methods: A systematic literature review on Medline was performed. A total of 21 papers were included in the present review. Results: Twenty-two MFS cases (77% males) were identified, 14 related to COVID-19 infection and 8 to vaccination against COVID-19. The median age of the adult patients was 50 years (interquartile range 36-63 years). Sixteen patients (73%) had the classic triad of MFS (ophthalmoplegia, ataxia, areflexia), four (18%) had acute ophthalmoplegia and one other characteristic symptom and two patients (9%) had only one other characteristic symptom, but they tested positive for GQ1b antibodies. Nine (41%) patients had positive GQ1b antibodies and were classified as "definite" MFS. Albuminocytologic dissociation was found in half of the cases. The outcome was favourable in the majority of cases (86%) whereas one patient, despite the initial improvement, died because of a cardiac arrest, after cardiac arrythmia. Conclusions: MFS after COVID-19 infection/vaccination was found to have the typical epidemiological characteristics of classic MFS; being rare, occurring more often after infection than vaccination, affecting mainly middle-aged males usually within 3 weeks after the event and having an excellent prognosis after treatment with IVIG or even with no treatment at all. We found no evidence that MFS after COVID-19 infection was different from MFS after COVID-19 vaccination, although the former tended to occur earlier.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Middle Aged ; COVID-19/prevention & control ; COVID-19/complications ; COVID-19 Vaccines/adverse effects ; Miller Fisher Syndrome/epidemiology ; Miller Fisher Syndrome/etiology ; Ophthalmoplegia/etiology ; SARS-CoV-2 ; Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines
Language	English
Publishing date	2023-07-19
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-023-02336-5
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Article ; Online: Miller Fisher syndrome associated with COVID-19: an up-to-date systematic review.

Li, Zheng / Li, Xingye / Shen, Jianxiong / Chan, Matthew T V / Wu, William Ka Kei

Environmental science and pollution research international

2021 Volume 28, Issue 17, Page(s) 20939–20944

Abstract: ... Miller Fisher syndrome" AND "COVID-19" OR "SARS-CoV-2". A systematic review from the first report of coronavirus disease ... especially Spain. There are 5 cases of MFS diagnosed after the laboratory confirmation of SARS-CoV-2 ... Recently, during the pandemic infection of the novel SARS-CoV-2, some cases ...

Abstract	Recently, during the pandemic infection of the novel SARS-CoV-2, some cases of Miller Fisher syndrome (MFS) have been reported. We want to summarize the main features of patients with MFS and COVID-19. A PubMed search was performed on 8 October to identify references reporting cases with MFS associated with COVID-19 from the first report of COVID-19 to 8 October 2020 using the following keywords: "Miller Fisher syndrome" AND "COVID-19" OR "SARS-CoV-2". A systematic review from the first report of coronavirus disease 2019 (COVID-19) to 8 October 2020 revealed 7 cases with Miller Fisher syndrome (MFS) associated with COVID-19. The 7 cases came from 5 countries but most of these patients were from Europe (85.7%), especially Spain. There are 5 cases of MFS diagnosed after the laboratory confirmation of SARS-CoV-2 infection. The mean onset time of MFS-associated neurological symptoms was 14.75 days after the diagnosis of COVID-19. However, the two remaining cases presented initially with MFS-associated neurological symptoms followed by the diagnosis of COVID-19. The most common symptoms of COVID-19-associated MFS were perioral paresthesias (57.1%), ataxia (57.1%), blurred vision (42.9), ophthalmoplegia (42.9), and generalized areflexia (42.9). However, more cohort and case-control studies are required to establish the epidemiological linkage.
MeSH term(s)	COVID-19 ; Europe ; Humans ; Miller Fisher Syndrome ; SARS-CoV-2 ; Spain
Language	English
Publishing date	2021-03-06
Publishing country	Germany
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	1178791-0
ISSN	1614-7499 ; 0944-1344
ISSN (online)	1614-7499
ISSN	0944-1344
DOI	10.1007/s11356-021-13233-w
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Article ; Online: Miller Fisher syndrome following BNT162b2 mRNA coronavirus 2019 vaccination.

Nishiguchi, Yamato / Matsuyama, Hirofumi / Maeda, Kuniko / Shindo, Akihiro / Tomimoto, Hidekazu

BMC neurology

2021 Volume 21, Issue 1, Page(s) 452

Abstract: ... by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. One of the vaccines approved against COVID-19 is ... old man with no history of the SARS-CoV-2 infection or any recent viral or bacterial illnesses ... such as infection.: Conclusion: Guillain-Barré syndrome (GBS) and its variants after COVID-19 vaccination are ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. One of the vaccines approved against COVID-19 is the BNT162b2 mRNA COVID-19 vaccine (Pfizer/BioNTech). Case presentation: We present the case of a 71-year-old man with no history of the SARS-CoV-2 infection or any recent viral or bacterial illnesses who presented with bilateral oculomotor palsy and limb ataxia after BNT162b2 mRNA COVID-19 vaccination. The diagnosis of Miller Fisher syndrome (MFS) was established based on physical examination, brain magnetic resonance imaging (MRI), cerebrospinal fluid analysis (CSF), and positron emission tomography (PET). There was no evidence of other predisposing infectious or autoimmune factors, and the period from COVID-19 vaccination to the appearance of neurological symptoms was similar to that of other vaccines and preceding events, such as infection. Conclusion: Guillain-Barré syndrome (GBS) and its variants after COVID-19 vaccination are extremely rare. Note that more research is needed to establish an association between MFS and COVID-19 vaccines. In our opinion, the benefits of COVID-19 vaccination largely outweigh its risks.
MeSH term(s)	Aged ; COVID-19 ; COVID-19 Vaccines ; Humans ; Male ; Miller Fisher Syndrome ; RNA, Messenger ; SARS-CoV-2 ; Vaccination
Chemical Substances	COVID-19 Vaccines ; RNA, Messenger ; BNT162 vaccine (N38TVC63NU)
Language	English
Publishing date	2021-11-18
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1471-2377
ISSN (online)	1471-2377
DOI	10.1186/s12883-021-02489-x
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Article ; Online: Guillain-Barré/Miller Fisher overlap syndrome in a patient after coronavirus disease-2019 infection: a case report.

Mohammadi, Seyede Momeneh / Abdi, Roghayeh / Karimi, Zeinab / Mortazavi, Fatemeh

Journal of medical case reports

2022 Volume 16, Issue 1, Page(s) 63

Abstract: ... axonal neuropathy, a variant of Guillain-Barré syndrome that overlaps Miller Fisher syndrome, 30 days ... of Guillain-Barré syndrome overlapping with Miller Fisher during the coronavirus disease-2019 pandemic ... occurrence of Guillain-Barré syndrome and Miller Fisher to improve the quality of life of these patients ...

Abstract	Background: Beyond the typical respiratory symptoms associated with novel coronavirus, increasing evidence has been reported of the neurological manifestations affecting both the central and peripheral nervous systems. Case presentation: We observed a 30-year-old Persian woman developing acute motor sensory axonal neuropathy, a variant of Guillain-Barré syndrome that overlaps Miller Fisher syndrome, 30 days after confirmed coronavirus disease-2019 infection. Our case highlight the rare occurrence of Guillain-Barré syndrome overlapping with Miller Fisher during the coronavirus disease-2019 pandemic. These neurologic manifestations may occur because of an aberrant immune response to coronavirus disease-2019. Conclusions: The early recognition of Guillain-Barré syndrome symptoms is critical, given the associated severe motor disabilities that may seriously limit the quality of life of these patients. We may still have much to learn about the co-occurrence of Guillain-Barré syndrome and Miller Fisher to improve the quality of life of these patients requiring an accurate evaluation by neurologists.
MeSH term(s)	Adult ; COVID-19 ; Female ; Guillain-Barre Syndrome/diagnosis ; Humans ; Miller Fisher Syndrome/complications ; Miller Fisher Syndrome/diagnosis ; Quality of Life ; SARS-CoV-2
Language	English
Publishing date	2022-02-08
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-021-03245-y
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Article ; Online: Atypical miller-fisher syndrome after COVID-19 and sleeve gastrectomy: Contribution of neurochemical markers to early diagnosis.

Zayet, Souheil / Zahra, Hajer / Belfeki, Nabil / Klopfenstein, Timothée / Hagenkötter, Beate

Infectious medicine

2022 Volume 1, Issue 2, Page(s) 140–142

Abstract: ... Conclusions: Guillain-Barré Syndrome and its variants after SARS-CoV-2 infection are extremely rare ... by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. More recently, there have been sporadic ... case reports on development of Miller-Fisher Syndrome , a rare variant of Guillain-Barré Syndrome in COVID-19 ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. More recently, there have been sporadic case reports on development of Miller-Fisher Syndrome , a rare variant of Guillain-Barré Syndrome in COVID-19 patients. Case report: We reported herein the case of a French young women presenting with ophtalmoplegia, cerebellar ataxia, and universal areflexia following a bariatric surgery (sleeve gastrectomy). A concomitant COVID-19 diagnosis was retained based on microbiological testing. The patient was successfully treated after high-dose intravenous thiamine, but areflexia persisted. Underlying COVID-19 related Miller-Fisher Syndrome was established on physical examination and confirmed by pathologic neurophysiological findings and elevated level of phosphorylated neurofilament heavy chain protein in cerebrospinal fluid analysis. Conclusions: Guillain-Barré Syndrome and its variants after SARS-CoV-2 infection are extremely rare. The measurement of phosphorylated neurofilament heavy chain protein should be considered as an easy tool to detect an early affection of the peripheral nervous system.
Language	English
Publishing date	2022-02-23
Publishing country	China
Document type	Case Reports
ISSN	2772-431X
ISSN (online)	2772-431X
DOI	10.1016/j.imj.2022.02.001
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