The human immune system is a complex mix of various cells, antibodies, and chemicals that regulate inflammation. However, sometimes this system misfires, attacking the very body it is meant to protect. This was the case with a man in his "x" age who arrived at our emergency department with acute onset walking difficulty and double vision. Upon examination, we found significant difficulty in maintaining balance and a squint with double vision when using both eyes.
After ruling out a stroke with an MRI scan, we obtained a detailed history and discovered a short fever ten days prior, associated with a few loose stools. He was clinically diagnosed with Miller-Fischer syndrome, a disease where the immune system attacks the body's nerves, leading to neurological manifestations such as double vision, imbalance, difficulty swallowing, and weakness in the limbs.
Early diagnosis and treatment can prevent complications such as respiratory muscle weakness, falls, and severe weakness. With the help of the nephrology team, we initiated plasmapheresis, a process similar to dialysis, which removes the chemicals and antibodies causing nerve damage. After just three series of plasmapheresis, the patient improved and began walking without support, with normal vision. He was discharged and, after one month of follow-up, was completely back to normal without any medication.
Early diagnosis of autoimmune diseases affecting the nervous system, such as GBS, multiple sclerosis, and myasthenia, can be cured through careful neurological examination. This can lead to early treatment and help prevent morbidity and mortality.