Proximal conduction abnormality of the facial nerve in Miller Fisher syndrome: A study using transcranial magnetic stimulation

Z. Arányi, Györgyi Szabó, Borbála Szepesi, András Folyovich

Research output: Article

6 Citations (Scopus)

Abstract

Objective: To investigate facial nerve conduction, including its proximal segment, in Miller Fisher syndrome. Methods: Three patients underwent facial nerve conduction studies comprising stylomastoid electrical stimulation and transcranial magnetic stimulation at the entrance of the facial canal within the skull and of the cortical representation area. All 3 patients presented with acute bilateral complete ophthalmoplegia, areflexia, mild ataxia and varying other symptoms. One of the patients had bilateral facial palsy; the other two had normal facial innervation. Results: Findings suggestive of demyelination of the proximal segment of the facial nerve were observed in each of the 3 patients with Miller Fisher syndrome. The patient with bilateral facial palsy had absent responses to canalicular stimulation on both sides, while the other two showed increased temporal dispersion and prolonged latency in the proximal nerve segments. Conclusions: Our findings suggest that the primary pathology of facial nerve lesion in Miller Fisher syndrome is demyelination and that it is localized to the proximal nerve segment. This is in line with the known vulnerability of proximal nerve segments (spinal roots) in other dysimmune demyelinating polyneuropathies. Significance: Facial nerve conduction study with magnetic stimulation can localize and detect even subclinical facial nerve dysfunction in patients with Miller Fisher syndrome. The technique may contribute to the diagnosis of this disease, where electrophysiologic findings are scanty.

Original languageEnglish
Pages (from-to)821-827
Number of pages7
JournalClinical Neurophysiology
Volume117
Issue number4
DOIs
Publication statusPublished - ápr. 2006

Fingerprint

Miller Fisher Syndrome
Transcranial Magnetic Stimulation
Facial Nerve
Neural Conduction
Facial Paralysis
Demyelinating Diseases
Ophthalmoplegia
Polyneuropathies
Spinal Nerve Roots
Ataxia
Skull
Electric Stimulation
Pathology

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems
  • Physiology (medical)

Cite this

Proximal conduction abnormality of the facial nerve in Miller Fisher syndrome : A study using transcranial magnetic stimulation. / Arányi, Z.; Szabó, Györgyi; Szepesi, Borbála; Folyovich, András.

In: Clinical Neurophysiology, Vol. 117, No. 4, 04.2006, p. 821-827.

Research output: Article

Arányi, Z. ; Szabó, Györgyi ; Szepesi, Borbála ; Folyovich, András. / Proximal conduction abnormality of the facial nerve in Miller Fisher syndrome : A study using transcranial magnetic stimulation. In: Clinical Neurophysiology. 2006 ; Vol. 117, No. 4. pp. 821-827.
@article{eaf3c3c9f97c4f7c90eba38eedc20ccb,
title = "Proximal conduction abnormality of the facial nerve in Miller Fisher syndrome: A study using transcranial magnetic stimulation",
abstract = "Objective: To investigate facial nerve conduction, including its proximal segment, in Miller Fisher syndrome. Methods: Three patients underwent facial nerve conduction studies comprising stylomastoid electrical stimulation and transcranial magnetic stimulation at the entrance of the facial canal within the skull and of the cortical representation area. All 3 patients presented with acute bilateral complete ophthalmoplegia, areflexia, mild ataxia and varying other symptoms. One of the patients had bilateral facial palsy; the other two had normal facial innervation. Results: Findings suggestive of demyelination of the proximal segment of the facial nerve were observed in each of the 3 patients with Miller Fisher syndrome. The patient with bilateral facial palsy had absent responses to canalicular stimulation on both sides, while the other two showed increased temporal dispersion and prolonged latency in the proximal nerve segments. Conclusions: Our findings suggest that the primary pathology of facial nerve lesion in Miller Fisher syndrome is demyelination and that it is localized to the proximal nerve segment. This is in line with the known vulnerability of proximal nerve segments (spinal roots) in other dysimmune demyelinating polyneuropathies. Significance: Facial nerve conduction study with magnetic stimulation can localize and detect even subclinical facial nerve dysfunction in patients with Miller Fisher syndrome. The technique may contribute to the diagnosis of this disease, where electrophysiologic findings are scanty.",
keywords = "Demyelination, Facial nerve, Magnetic stimulation, Miller Fisher syndrome",
author = "Z. Ar{\'a}nyi and Gy{\"o}rgyi Szab{\'o} and Borb{\'a}la Szepesi and Andr{\'a}s Folyovich",
year = "2006",
month = "4",
doi = "10.1016/j.clinph.2005.12.006",
language = "English",
volume = "117",
pages = "821--827",
journal = "Clinical Neurophysiology",
issn = "1388-2457",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

TY - JOUR

T1 - Proximal conduction abnormality of the facial nerve in Miller Fisher syndrome

T2 - A study using transcranial magnetic stimulation

AU - Arányi, Z.

AU - Szabó, Györgyi

AU - Szepesi, Borbála

AU - Folyovich, András

PY - 2006/4

Y1 - 2006/4

N2 - Objective: To investigate facial nerve conduction, including its proximal segment, in Miller Fisher syndrome. Methods: Three patients underwent facial nerve conduction studies comprising stylomastoid electrical stimulation and transcranial magnetic stimulation at the entrance of the facial canal within the skull and of the cortical representation area. All 3 patients presented with acute bilateral complete ophthalmoplegia, areflexia, mild ataxia and varying other symptoms. One of the patients had bilateral facial palsy; the other two had normal facial innervation. Results: Findings suggestive of demyelination of the proximal segment of the facial nerve were observed in each of the 3 patients with Miller Fisher syndrome. The patient with bilateral facial palsy had absent responses to canalicular stimulation on both sides, while the other two showed increased temporal dispersion and prolonged latency in the proximal nerve segments. Conclusions: Our findings suggest that the primary pathology of facial nerve lesion in Miller Fisher syndrome is demyelination and that it is localized to the proximal nerve segment. This is in line with the known vulnerability of proximal nerve segments (spinal roots) in other dysimmune demyelinating polyneuropathies. Significance: Facial nerve conduction study with magnetic stimulation can localize and detect even subclinical facial nerve dysfunction in patients with Miller Fisher syndrome. The technique may contribute to the diagnosis of this disease, where electrophysiologic findings are scanty.

AB - Objective: To investigate facial nerve conduction, including its proximal segment, in Miller Fisher syndrome. Methods: Three patients underwent facial nerve conduction studies comprising stylomastoid electrical stimulation and transcranial magnetic stimulation at the entrance of the facial canal within the skull and of the cortical representation area. All 3 patients presented with acute bilateral complete ophthalmoplegia, areflexia, mild ataxia and varying other symptoms. One of the patients had bilateral facial palsy; the other two had normal facial innervation. Results: Findings suggestive of demyelination of the proximal segment of the facial nerve were observed in each of the 3 patients with Miller Fisher syndrome. The patient with bilateral facial palsy had absent responses to canalicular stimulation on both sides, while the other two showed increased temporal dispersion and prolonged latency in the proximal nerve segments. Conclusions: Our findings suggest that the primary pathology of facial nerve lesion in Miller Fisher syndrome is demyelination and that it is localized to the proximal nerve segment. This is in line with the known vulnerability of proximal nerve segments (spinal roots) in other dysimmune demyelinating polyneuropathies. Significance: Facial nerve conduction study with magnetic stimulation can localize and detect even subclinical facial nerve dysfunction in patients with Miller Fisher syndrome. The technique may contribute to the diagnosis of this disease, where electrophysiologic findings are scanty.

KW - Demyelination

KW - Facial nerve

KW - Magnetic stimulation

KW - Miller Fisher syndrome

UR - http://www.scopus.com/inward/record.url?scp=33644885708&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644885708&partnerID=8YFLogxK

U2 - 10.1016/j.clinph.2005.12.006

DO - 10.1016/j.clinph.2005.12.006

M3 - Article

C2 - 16442344

AN - SCOPUS:33644885708

VL - 117

SP - 821

EP - 827

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

IS - 4

ER -