Avtor/Urednik		Najim Al-Din, S; Anderson, M; Eeg-Olofsson, O; Trontelj, JV
Naslov		Neuro-ophthalmic manifestations of the syndrome of ophthalmoplegia, ataxia and areflexia: a review
Tip		članek
Vir		Acta Neurol Scand
Vol. in št.		Letnik 89
Leto izdaje		1994
Obseg		str. 157-63
Jezik		eng
Abstrakt		Controversy regarding the nosological position of the syndrome of ophthalmoplegia, ataxia and areflexia (Miller Fisher syndrome) exists. The oculomotor dysfunction was presumed to represent an unusually symmetrical peripheral cranial nerve dysfunction. To investigate the neuro-ophthalmic manifestations in this rare syndrome we reviewed 109 reports describing 243 cases. The ophthalmoplegia was remarkable in its constant association with a cerebellar type ataxia. It was described to be remarkably symmetrical at all stages of development and recovery. From the early descriptionof the syndrome by Fisher the ophthalmoplegia was observed to evolve as a symmetrical failure of upgaze followed by loss of lateral gaze and last by downgaze, recovery develops in the opposite pattern. Despite the severe nature of the ophthalmoplegia, 58 patients were reported to have sparing of downgaze and 192 (79%) had relative sparing of the eye lids. Active lid retraction and preserved Bell's phenomenon, despite upgaze paralysis, were described in 22 and 15 patients respectively. Upper lid jerks were described in 2, Parinaud's syndrome in 2, convergence spasm in 6, internuclear ophthalmoplegia in 15 and horizontal dissociated nystagmus in 11. Interestingly 23 were reported to present with paralysis of abduction progressing to lateral gaze paralysis and 5 had paralysis of obduction and contralateral gaze paralysis. Four had defective vestibulo-ocular reflex despite recovery of upgaze, 10 had central type nystagmus including rotatory, retractory and rebound nystagmus. Relative preservationof optokinetic nystagmus and preservation of vestibulo-ocular reflex despite an otherwise complete ophthalmoplegia were repoted in 6 and 2 patients repectively.(Abstract truncated at 2000 characters.
Deskriptorji		OPHTHALMOPLEGIA CEREBELLAR ATAXIA OCULOMOTOR NERVE BLEPHAROPTOSIS BRAIN STEM EYE MOVEMENTS NYSTAGMUS REFLEX, ABNORMAL