米勒·费希尔综合征的临床研究

Clinical research on Miller Fisher syndrome

目的探讨米勒·费希尔综合征的临床特点并对其进行综述。方法回顾分析8例米勒.费希尔综合征患者的临床特点。结果主要神经系统症状:头晕,恶心呕吐,视物模糊,视物成双,四肢无力,手足发麻感,行走不稳。主要神经系统体征:瞳孔直接及间接对光反射消失,双侧眼外肌麻痹,水平眼震,周围性面瘫,共济失调,深、浅感觉减退,腱反射减弱或消失。首发症状主要表现为头晕、视物成双和四肢无力。脑脊液蛋白升高8例,脑脊液细胞数无升高病例。肌电图检查示神经源性损害4例,脑电图异常3例。CT和MRI检查发现异常1例。激素和人血免疫球蛋白同时使用可有效缓解病情,7例患者出院时症状明显好转,1例不明显。结论米勒.费希尔综合征主要累及周围神经系统,临床表现相似,大多数预后较好。

Objective To study the clinical features of Miller Fisher syndrome and overview. Methods Retrospective analysis was performed on eight patients with Miller Fisher syndrome, who had been admitted to the hospital. They all met criteria for Mille-Fisher syndrome. Results The major symptoms of nervous system included dizziness,diplopia, mild limb weakness, par aesthesia of extremity, gait disturbance and autonomic dysfunction. The major physical sign included： disappearance of pupil direct and indirect light reflex, ophthalmoplegia externa, nystagmus,ataxia, hypesthesia, superficial sense impairment, deep sense impairment, peripheral facial paralysis, and weak or disappeared tendons. Initial symptoms included： dizziness, diplopia and mild limb weakness. Increased total protein （8 patients） and normal cellularity （8 patients） were detected in the cerebrospinal fluid. Three patients were found myelin sheath and auxiliary fibers injury simultaneously in electromyologram（EMG）. Three patients were found in electroencephalogram （EEG）. Only one was abnormal findings in computer tomography （CT） or magnetic resonance imaging （MRI）. Use of gamma globulin or hormone had good therapeutic effect, seven patients improved symptoms obviously at discharge,one was not obvious in effect. Conclusion Miller Fisher syndrome mainly involves peripheral nervous system with similar clinical manifestation and good prognosis.