A clinical analysis of the initial symptoms and clinical course of patients diagnosed with Fisher syndrome following a visit to the Department of Otolaryngology

Abstract

Fisher syndrome (FS) is an acute disorder characterized by the triad of ataxia, ophthalmoplegia, and areflexia/hyporeflexia. Anti-GQ1b IgG antibody leads to symptoms of FS. We herein report the case of a 70-year-old woman who first presented with vertigo. On admission, she showed gaze nystagmus and ataxia, and hyporeflexia was found. She subsequently developed ophthalmoplegia. A neurologist diagnosed her with FS. Anti-GQ1b IgG antibody was positive. She was treated with intravenous immunoglobulin and showed a complete response. We also examined the initial symptoms and clinical course of patients diagnosed with FS following a visit to the Department of Otolaryngology in the literature. The initial symptoms were as follows: ataxia, 5/12 (42%); diplopia, 5/12 (42%) and vertigo, 2/12 (17%). Four of 5 (80%) patients with diplopia demonstrated sinusitis on imaging before consulting the Department of Otolaryngology. Therefore, the initial symptoms of the patients who visited the Department of Otolaryngology could be divided into two groups, as follows: ataxia and vertigo related to disequilibrium, and diplopia as demonstrated by sinusitis on imaging examinations.