Reversible conduction failure in overlap of Miller Fisher syndrome and pharyngeal-cervical-brachial variant of Guillain-Barre syndrome in the spectrum of nodo-paranodopathies

Abstract

Patients with an overlap of the pharyngeal-cervical-brachial variant of Guillain-Barre syndrome and Miller Fisher syndrome (PCB/MFS) have rarely been reported. The electrophysiological findings in PCB/MFS are of great interest and may provide insight into the pathophysiology of the disorder. We report the clinical features and nerve conduction study findings in a patient with PCB/MFS with high titers of antiganglioside antibodies against GQ1b, GD1a, and GD1b. In serial nerve conduction studies, compound muscle action potential amplitudes normalised without development of temporal dispersion within 3 weeks, and absent median, ulnar, and sural sensory nerve action potentials became recordable within 4 months. These findings are consistent with reversible conduction failure in both motor and sensory fibres, and PCB/MFS could be classified in the recently described nodo-paranodopathy spectrum of acute neuropathies associated with anti-ganglioside antibodies. (c) 2013 Elsevier Ltd. All rights reserved.