J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 15, Number 11, November 2024, pages 341-346

Rapid Resolution of Delayed Facial Palsy in Miller Fisher Syndrome With Steroid Therapy

**Table 1.** Summary of Current and Previous Case Reports on the Clinical Features of Delayed Facial Palsy in Miller Fisher Syndrome
Case	Age/sex	Antecedent illness	Immunotherapy/time of initiation (days)	Nadir of symptoms (days)	Improvement in symptoms (days)	Peripheral type-facial palsy	Additional therapy	Antibody profile
oPSL: oral prednisolone; MP: methylprednisolone; IVIG: intravenous immunoglobulin; PLEX: plasmapheresis; U/l: unilateral; B/l: bilateral; N/a: not available; URTI: upper respiratory tract infection; GM1: ganglioside-monosialic acid; GQ1b: gangliosdie-Q1b.
Our case	37/M	URTI	IVIG/7	9	11	14	22	U/l	oPSL	GQ1b
Tan et al [3]
3.1	52/M	N/a	IVIG/7	9	12	14	66	U/l	-	Negative
3.2	45/M	URTI	PLEX/6	6	14	12	35	B/l	-	GQ1b, GT1a GD1b
3.3	21/F	URTI	N/a	4	7	8	64	B/l	-	GQ1b, GT1a
3.4	57/F	URTI	PLEX/6	6	9	14	43	U/l	-	GQ1b, GT1a
Tatsumoto et al [6]
6.1	35/M	URTI	N/a	5	6	15	21	U/l	-	GQ1b
6.2	32/M	URTI	IVIG /N/a	6	10	10	21	B/l	-	GQ1b
6.3	18/M	URTI	IVIG/N/a	6	8	10	21	B/l	-	N/a
6.4	29/F	URTI	N/a	10	18	11	21	U/l	-	GQ1b
Kim et al [7]
7.1 - 7.11 (mean values for 11 cases)	34/(M: 7; F: 4)	URTI: 6; diarrhea:4	IVIG/N/a	10	13	12	<30	U/l in 4; B/l in 7	IVIG in five patients	GQ1b in 7
Fisher et al [8]
8.1	45/M	URTI	-	5	8	13	42	U/l	-	Negative
Umekawa et al [9]
9.1	47/M	N/a	IVIG/4	6	11	14	N/a	B/l	-	GQ1b
Yamamoto et al [10]
10.1	55/M	URTI	IVIG/6	6	11	13	42	U/l	-	GQ1b
Jung et al [11]
11.1	23/M	N/a	IVIG/N/a	7	11	16	60	B/l	-	N/a
11.2	50/M	N/a	IVIG/N/a	4	7	10	60	U/l	-	GQ1b
11.3	57/M	N/a	IVIG/N/a	9	20	15	60	U/l	-	N/a
Kwon et al [12]
12.1	25/M	N/a	IVIG/6	N/a	N/a	12	42	U/l	-	N/a
12.2	48/F	N/a	IVIG/7	N/a	N/a	16	84	U/l	-	N/a
12.3	52/M	N/a	IVIG/3	N/a	N/a	11	84	B/l	-	N/a
12.4	56/M	N/a	IVIG/3	N/a	N/a	8	84	U/l	-	N/a
Port et al [13]
13.1	20/F	N/a	IVIG/N/a	N/a	N/a	10	85	B/l	-	GQ1b
Chida el al [14]
14.1	65/M	URTI	PLEX/10	8	14	17	45	B/l	PLEX	GQ1b
14.2	60/M	N/a	PLEX/4	4	10	12	36	B/l	MP	GQ1b
Sakel et al [15]
15.1	67/M	N/a	IVIG/N/a	N/a	N/a	10	N/a	B/l	IVIG	N/a
Liu et al [16]
16.1	40/M	URTI	IVIG/5	4	9	10	33	B/l	MP	GM1
Nanatsue et al [17]
17.1	70/M	URTI	IVIG/2	5	N/a	7	30	U/l	oPSL	GQ1b
Watanabe et al [18]
18.1	35/M	URTI	PLEX/6	10	11	12	24	U/l	MP f/b oPSL	GQ1b, GT1a
18.2	46/F	URTI	IVIG/4	4	5	9	31	U/l	MP f/b oPSL	GQ1b
18.3	21/F	Diarrhea	IVIG/3	3	5	9	33	U/l	MP f/b oPSL	GQ1b, GT1b

Table 1. Summary of Current and Previous Case Reports on the Clinical Features of Delayed Facial Palsy in Miller Fisher Syndrome

Case

Age/sex

Antecedent illness

Immunotherapy/time of initiation (days)

Nadir of symptoms (days)

Improvement in symptoms (days)

Peripheral type-facial palsy

Additional therapy

Antibody profile

Appearance (days)

Resolution (days)

Side

oPSL: oral prednisolone; MP: methylprednisolone; IVIG: intravenous immunoglobulin; PLEX: plasmapheresis; U/l: unilateral; B/l: bilateral; N/a: not available; URTI: upper respiratory tract infection; GM1: ganglioside-monosialic acid; GQ1b: gangliosdie-Q1b.

Our case

37/M

URTI

IVIG/7

U/l

oPSL

GQ1b

Tan et al [3]

3.1

52/M

N/a

IVIG/7

U/l

Negative

3.2

45/M

URTI

PLEX/6

B/l

GQ1b, GT1a
GD1b

3.3

21/F

URTI

N/a

B/l

GQ1b, GT1a

3.4

57/F

URTI

PLEX/6

U/l

GQ1b, GT1a

Tatsumoto et al [6]

6.1

35/M

URTI

N/a

U/l

GQ1b

6.2

32/M

URTI

IVIG /N/a

B/l

GQ1b

6.3

18/M

URTI

IVIG/N/a

B/l

N/a

6.4

29/F

URTI

N/a

U/l

GQ1b

Kim et al [7]

7.1 - 7.11 (mean values for 11 cases)

34/(M: 7; F: 4)

URTI: 6; diarrhea:4

IVIG/N/a

<30

U/l in 4; B/l in 7

IVIG in five patients

GQ1b in 7

Fisher et al [8]

8.1

45/M

URTI

U/l

Negative

Umekawa et al [9]

9.1

47/M

N/a

IVIG/4

N/a

B/l

GQ1b

Yamamoto et al [10]

10.1

55/M

URTI

IVIG/6

U/l

GQ1b

Jung et al [11]

11.1

23/M

N/a

IVIG/N/a

B/l

N/a

11.2

50/M

N/a

IVIG/N/a

U/l

GQ1b

11.3

57/M

N/a

IVIG/N/a

U/l

N/a

Kwon et al [12]

12.1

25/M

N/a

IVIG/6

N/a

U/l

N/a

12.2

48/F

N/a

IVIG/7

N/a

U/l

N/a

12.3

52/M

N/a

IVIG/3

N/a

B/l

N/a

12.4

56/M

N/a

IVIG/3

N/a

U/l

N/a

Port et al [13]

13.1

20/F

N/a

IVIG/N/a

N/a

B/l

GQ1b

Chida el al [14]

14.1

65/M

URTI

PLEX/10

B/l

PLEX

GQ1b

14.2

60/M

N/a

PLEX/4

B/l

GQ1b

Sakel et al [15]

15.1

67/M

N/a

IVIG/N/a

N/a

B/l

IVIG

N/a

Liu et al [16]

16.1

40/M

URTI

IVIG/5

B/l

GM1

Nanatsue et al [17]

17.1

70/M

URTI

IVIG/2

N/a

U/l

oPSL

GQ1b

Watanabe et al [18]

18.1

35/M

URTI

PLEX/6

U/l

MP f/b oPSL

GQ1b, GT1a

18.2

46/F

URTI

IVIG/4

U/l

MP f/b oPSL

GQ1b

18.3

21/F

Diarrhea

IVIG/3

U/l

MP f/b oPSL

GQ1b, GT1b