Morning Report: An Uncommon Presentation of an Uncommon Disease

Clinical Pearls:

  • Guillan-Barre Miller Fisher Variant: Classical triad is ophthalmoplegia, ataxia, areflexia but all three are not necessary. About 25% of these patients will have limb weakness. Additionally, you can see a descending paralysis rather than ascending paralysis.
  • Romberg Test: Maintaining balance while standing requires 2 out of 3 of the following – Proprioception, vision, vestibular apparatus. Patient’s with cerebellar ataxia will generally be unable to balance with their eyes open so the Rhomberg’s test is not a test of cerebellar function.
  • Albumino-cytologic dissociation on LP, preceding viral URI or Gastroenteritis, 30% Campylobacter
  • TCA Toxicity can cause numbness, tingling, transaminitis, extrapyramidal symptoms, ataxia.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s