A 47-Year-Old With Diplopia, Limb Tingling, and Imbalance

Sujatha R. Borra, MD; Rahul R. Borra; Darshan Rola; Neal T. Patel


August 03, 2021

A multidisciplinary neurologic care team treated this patient. The treatment of Miller Fisher syndrome is highlighted by supportive care because no cure is available.

Intravenous immunoglobulin is the first-line therapy for more severe cases of Miller Fisher syndrome. The recommended dosage is 2 g/kg divided over 2-5 days. A second treatment course may be necessary for some patients. In children and adolescents, a dosage of 1 g/kg per dose intravenously daily for 2 days is recommended. Alternatively, a dosage of 400 mg/kg per dose intravenously daily for 5 days has been used.[3]

In this patient, the standard treatment regimen was given for the entire duration of 5 days in order to fully ensure symptom reduction. Rehabilitation therapy was provided in the office as well as at his home and included both physical and occupational therapy. Follow-up visits showed that the patient's symptoms were markedly reduced and that normal limb function was slowly returning.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.