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Japanese

ELECTROPHYSIOLOGICAL STUDY OF A PATIENT WITH FISHER'S SYNDROME Tomokazu Goya 1 , Mamoru Yoshida 1 , Yasuhiko Matsukado 1 , Tatsuhiko Kano 2 1Department of Neurosurgery Kumamoto University Medical School 2Department of Anesthesiology Kumamoto University Medical School pp.307-314
Published Date 1977/3/1
DOI https://doi.org/10.11477/mf.1406204038
  • Abstract
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A 41-year-old bus driver developed headache,double vision and staggering gait, preceded bycommon cold like symptoms for one week. Onadmission neurological examination revealed ptosis,dilated pupils, absent light reflex, almost totallyimpaired external ocular movement, cerebellardiscoordination, ataxic gait and absent DTRs. Alsotransient paresthesia was noted on face and handsat the initial stage. The csf protein increased ashigh as 98 mg/dl with normal cell count. Thepatient had classical triad of Fisher's syndrome,which were total ophthalmoplegia, ataxia andareflexia. The improvement of clinical symptomswas very slow and repeated electrophysiological ex-amination of the characteristic triad was performed,and the following conclusion was obtained: 1)concerning with the ophthalmoplegia, the site oflesions was supposed to be adjacent to the oculo-motor nuclei and was accompanied by some peri-pheral involvement, because of concomitant recoveryof the voluntary and the reflactory eye movementsand the presence of saccadation at the stage ofrecovery. 2) ataxia was supposed to be cerebellarin origin and the possibility was pointed out thatthe spinocerebellar tract was partly involved to theataxia. 3) at the stage of recovery H reflex of theevoked myogram was high in threshold and theposttetatic potentiation was observed but minimal.4) according to the examination of the spinal rootaction potentials GIa and α-motoneurons weremaintained functionally normal, which was evi-denced clinically by no weakness and hypotonia ofthe muscles. These findings indicated that areflexiawas mainly due to disturbance of the synaptictransmission with a slight possibility of the supra-spinal influences to the synaptic pathways.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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