Bilateral vocal cord paralysis in Miller Fisher syndrome/Guillain-Barre overlap syndrome and a review of previous case series

BMJ Case Rep. 2021 Jan 27;14(1):e240386. doi: 10.1136/bcr-2020-240386.

Abstract

Miller Fisher syndrome (MFS), an acute demyelinating neuropathy, is characterised by a triad of areflexia, ataxia and ophthalmoplegia. It is the most common variant of Guillain-Barre Syndrome (GBS). In about 5.6%-7.1% of MFS cases, patients also suffer from progressive motor weakness of the limbs. This condition is termed MFS/GBS overlap syndrome. Whether it is in MFS or GBS, bilateral vocal cord paralysis (BVCP) is a rare manifestation with limited cases reported in the literature. We report an extremely rare case where a 65-year-old man developed BVCP in an MFS/GBS overlap syndrome. We have also reviewed previous case reports in the literature for comparison.

Keywords: adult intensive care; ear, nose and throat/otolaryngology; neuro ITU; neurology; peripheral nerve disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acyclovir / therapeutic use
  • Aged
  • Antiviral Agents / therapeutic use
  • Chickenpox / complications
  • Chickenpox / drug therapy
  • Disease Progression
  • Electrodiagnosis
  • Guillain-Barre Syndrome / complications
  • Guillain-Barre Syndrome / physiopathology*
  • Guillain-Barre Syndrome / therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Male
  • Miller Fisher Syndrome / complications
  • Miller Fisher Syndrome / physiopathology*
  • Miller Fisher Syndrome / therapy
  • Neural Conduction
  • Tracheostomy
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / physiopathology*

Substances

  • Antiviral Agents
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Acyclovir