Abstract
Two cases of Fisher's Syndrome were reported and reviewed from the neuro-otological point of view.
Case 1: A 20-year-old man, 3 days after upper respiratory infection and diarrhea, complained of diplopia, ophthalmoplegia and ataxia. Neuro-otological examinations revealed dysdiadochokinesis, gaze nystagmus in both directions and direction-changing nystagmus to the uppermost ear. The righting reflex test, stepping test and rotation test were within normal limits. Eye movements were grossly limited but gradually improved afterwards. Optokinetic pattern test (OKP) and Eye tracking test (ETT) were almost normal. These results suggest that the lesion is located within the central nervous system, especially in the brain stem and cerebellum.
Case 2: A 20-year-old man, several days after upper respiratory infection and diarrhea, complained of general fatigue, numbness of the whole body, diplopia, ataxia, dysarthria and dysphagia.
Neuro-otological examination revealed ataxic gait, dysdiadochokinesis, gaze nystagmus in both directions. No positional and positioning nystagmus were seen. The results of OKP and ETT indicated the disturbance of the brain stem and cerebellum. These results suggest that the lesion was within the brain stem and cerebellum.
The exact site of the lesion of Fisher's Syndrome is still obscure, Several authors suggested the peripheral origin, where as the others claimed central nervous system involvement. The results of the neuro-otological examinations in our cases suggest involvement of the brain stem and cerebellum in Fisher's Syndrome.
