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Lesion Site in Fisher's Syndrome

Lesion Site in Fisher's Syndrome Abstract To the Editor. —In his editorial,1 Ropper commented on the article by Ryffel and myself about supranuclear eye movement disorders in Fisher's syndrome.2 He discussed the question of CNS involvement in Guillain-Barré syndrome (GBS), as though Fisher's syndrome is simply a variant. Although this assumption is widely held, as far as we know, correct evidence supporting it has never been provided. Undoubtedly, similarities between the two syndromes, such as a preceding respiratory tract or other infections and an increased CSF protein level, suggest similar pathogenetic mechanisms. These common characteristics, however, by no means necessarily allow conclusions about the anatomic site of the lesion and the structures involved.To support the argument that Fisher's syndrome is really a variant of GBS, the autopsy cases used to show absence of CNS lesions in Fisher's syndrome should at least have the disease's essential clinical features. In the cases cited by Ropper References 1. Ropper AH: The CNS in Guillain-Barré syndrome . Arch Neurol 1983;40:397-398.Crossref 2. Meienberg O, Ryffel E: Supranuclear eye movement disorders in Fisher's syndrome of ophthalmoplegia, ataxia, and areflexia: Report of a case and literature review . Arch Neurol 1983; 40:402-405.Crossref 3. Richter R: The ataxic form of polyradiculoneuropathy (Landry-Guillain-Barré syndrome): Clinical and pathologic observations . J Neuropathol Exp Neurol 1962;21:171-184.Crossref 4. Asbury A, Aranson B, Adams R: The inflammatory lesion in idiopathic polyneuritis . Medicine 1969;48:173-215.Crossref 5. Bignami A, Servi M: Acute internal and external ophthalmoplegia with muscle weakness . Lancet 1963;1:1110.Crossref 6. Haymaker W, Kernohan J: The Landry-Guillain-Barré syndrome: A clinicopathologic report of 50 fatal cases and a critique of the literature . Medicine 1949;28:59-141.Crossref 7. Grunnet M, Lubow M: Ascending polyneuritis and ophthalmoplegia . Am J Ophthalmol 1972; 74:1155-1160. 8. Al-Din AM, Anderson M, Bickerstaff E, et al: Brainstem encephalitis and the syndrome of Miller Fisher . Brain 1982;105:481-495.Crossref 9. Barontini F, Sita D: The nosological position of Fisher's syndrome (ophthalmoplegia, ataxia and areflexia) . J Neurol 1983;229:33-44.Crossref 10. Henn V, Hepp K, Büttner-Ennever JA: The primate oculomotor system: II. Premotor system . Hum Neurobiol 1982;1:87-95. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Lesion Site in Fisher's Syndrome

Archives of Neurology , Volume 41 (3) – Mar 1, 1984

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1984.04050150028006
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —In his editorial,1 Ropper commented on the article by Ryffel and myself about supranuclear eye movement disorders in Fisher's syndrome.2 He discussed the question of CNS involvement in Guillain-Barré syndrome (GBS), as though Fisher's syndrome is simply a variant. Although this assumption is widely held, as far as we know, correct evidence supporting it has never been provided. Undoubtedly, similarities between the two syndromes, such as a preceding respiratory tract or other infections and an increased CSF protein level, suggest similar pathogenetic mechanisms. These common characteristics, however, by no means necessarily allow conclusions about the anatomic site of the lesion and the structures involved.To support the argument that Fisher's syndrome is really a variant of GBS, the autopsy cases used to show absence of CNS lesions in Fisher's syndrome should at least have the disease's essential clinical features. In the cases cited by Ropper References 1. Ropper AH: The CNS in Guillain-Barré syndrome . Arch Neurol 1983;40:397-398.Crossref 2. Meienberg O, Ryffel E: Supranuclear eye movement disorders in Fisher's syndrome of ophthalmoplegia, ataxia, and areflexia: Report of a case and literature review . Arch Neurol 1983; 40:402-405.Crossref 3. Richter R: The ataxic form of polyradiculoneuropathy (Landry-Guillain-Barré syndrome): Clinical and pathologic observations . J Neuropathol Exp Neurol 1962;21:171-184.Crossref 4. Asbury A, Aranson B, Adams R: The inflammatory lesion in idiopathic polyneuritis . Medicine 1969;48:173-215.Crossref 5. Bignami A, Servi M: Acute internal and external ophthalmoplegia with muscle weakness . Lancet 1963;1:1110.Crossref 6. Haymaker W, Kernohan J: The Landry-Guillain-Barré syndrome: A clinicopathologic report of 50 fatal cases and a critique of the literature . Medicine 1949;28:59-141.Crossref 7. Grunnet M, Lubow M: Ascending polyneuritis and ophthalmoplegia . Am J Ophthalmol 1972; 74:1155-1160. 8. Al-Din AM, Anderson M, Bickerstaff E, et al: Brainstem encephalitis and the syndrome of Miller Fisher . Brain 1982;105:481-495.Crossref 9. Barontini F, Sita D: The nosological position of Fisher's syndrome (ophthalmoplegia, ataxia and areflexia) . J Neurol 1983;229:33-44.Crossref 10. Henn V, Hepp K, Büttner-Ennever JA: The primate oculomotor system: II. Premotor system . Hum Neurobiol 1982;1:87-95.

Journal

Archives of NeurologyAmerican Medical Association

Published: Mar 1, 1984

References