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

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

Disclosures

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.

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