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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:645-648, April 2004
© 2004 American Society of Neuroradiology

Case Report
SPINE

MR Imaging Findings of Spinal Posterior Column Involvement in a Case of Miller Fisher Syndrome

Nobuhiro Inoue^a, Homare Ichimura^a, Satoshi Goto^b, Yoichiro Hashimoto^c and Yukitaka Ushio^b

^a Department of Neurosurgery, Health and Insurance Hitoyoshi General Hospital, Kumamoto, Japan
^b Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
^c Department of Neurology, Kumamoto Citizen’s Hospital, Kumamoto, Japan

Address correspondence to N. Inoue, MD, PhD, Department of Neurosurgery, Kumamoto Neurosurgical Hospital, 6–1-21 Honjo, Kumamoto, 860-0811 Japan

Summary: The site of lesions causing ataxia in Miller Fisher syndrome (MFS) remains in dispute. A 43-year-old man manifested rapidly progressive left-sided ptosis, bilateral abducens palsy, areflexia, and severe ataxia. Initial MR imaging showed confined lesions of the cauda equina with gadolinium enhancement. A diagnosis of MFS was made, and the patient underwent immunotherapy. His ophthalmoplegia disappeared, but other symptoms remained. Five months after onset, MR imaging disclosed lesions confined to the spinal posterior column, which were considered to result from involvement of posterior nerve roots of the cauda equina and to be responsible for his remaining severe ataxia.