National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Miller-Fisher syndrome


Other Names:
Cranial variant of Guillain-Barré syndrome; Cranial variant of GBS
Categories:
Miller Fisher syndrome is a rare acquired nerve disease considered to be a variant of Guillain-Barré syndrome.[1] The main features are lack of muscle coordination (ataxia), eye muscle weakness resulting in the inability to move the eyes in several directions (ophthalmoplegia), and the absence of tendon reflexes. Symptoms often start several days after a viral illness.[1][2][3] Other symptoms include generalized muscle weakness and respiratory failure. The cause is not known, but it is thought to be an autoimmune disease in which there are autoantibodies that attack the nerves. In most people with Miller Fisher syndrome an antibody (anti-GQ1b) is identified. The presence of these autoantibodies helps confirm the diagnosis of the syndrome.[3] Treatment includes intravenous immunoglobulin (IVIG), plasmapheresis (a plasma exchange procedure in which the antibodies are removed from the blood) and supportive care. The prognosis is usually good, and in most cases, there is almost complete recovery within 6 months.[3][4] In rare cases, the syndrome may progress and permanent neurological deficits may be present.[3][4][5]
Last updated: 10/31/2017

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
The clinical picture in MFS shows clinical overlap with Bickerstaff brainstem encephalitis (BBE; see this term), which is also associated with raised titers of anti-GQ1b antibodies, leading to the suggestion that BBE and MFS represent variable manifestations of the same clinical spectrum. However, patients with BBE also have central nervous system involvement leading to disturbed consciousness and in some cases tetraparalysis with involvement of cranial nerves (including the intraocular nerves leading to fixed pupils).
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Miller-Fisher syndrome. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Miller-Fisher syndrome. Click on the link to view a sample search on this topic.

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  1. NINDS Miller Fisher Syndrome Information Page. NINDS. August 2011; http://www.ninds.nih.gov/disorders/miller_fisher/miller_fisher.htm. Accessed 10/21/2011.
  2. Miller-Fisher syndrome. Radiopaedia. https://radiopaedia.org/articles/miller-fisher-syndrome.
  3. Miller-Fisher syndrome. GBS/CIDP Foundation International. https://www.gbs-cidp.org/variants/miller-fisher-syndrome/.
  4. Verboon C, van Berghem H, van Doorn PA, Ruts L & Jacobs BC. Prediction of disease progression in Miller Fisher and overlap syndromes. J Peripher Nerv Syst. October 24, 2017; https://www.ncbi.nlm.nih.gov/pubmed/29065229.
  5. Barbato F, Di Paolantonio A, Distefano M, Mastrorosa A, Sabatelli M, Servidei S & Luigetti M. Recurrent miller fisher: a new case report and a literature review. Clin Ter. May-June, 2017; 168(3)::208-213. https://www.ncbi.nlm.nih.gov/pubmed/28612899.