[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
August 1994

Lupus Erythematosus and Miller-Fisher Syndrome

Author Affiliations

From the Departments of Internal Medicine (Drs Bingisser, Speich, Fontana, and Gmür) and Neurology (Drs Vogel and Landis), University Hospital, Zürich, Switzerland.

Arch Neurol. 1994;51(8):828-830. doi:10.1001/archneur.1994.00540200108024

Objective:  To compare the clinical course of an unusual case of Miller-Fisher syndrome in systemic lupus erythematosus with therapeutic interventions, in particular with plasma exchanges.

Design:  The clinical state and laboratory and electrophysiologic parameters were controlled for over a year and related to therapeutic attempts with immunoglobulins, steroids, and plasma exchanges.

Setting:  Medical intensive care unit of a university hospital.

Patient:  A 17-year-old black female student with known systemic lupus erythematosus who developed ataxia, areflexia, and ophthalmoplegia (Miller-Fisher syndrome) and later became tetraplegic and required full mechanical ventilatory support.

Results:  High-dose immunoglobulin treatment combined with corticosteroid pulse therapy was not beneficial. However, plasma exchange (performed five times over a period of 4 months) was followed by a striking clinical improvement within hours after each plasma exchange.

Conclusions:  Plasma exchange appears to remove a yet unknown agent producing a distal motor nerve conduction block and is efficacious in severe neuropathy associated with Miller-Fisher syndrome in lupus erythematosus.