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Allan Ropper, MD
Neurology-Neurosurgery Intensive Care Unit Massachusetts General Hospital Fruit Street Boston, MA 02114

Arch Neurol. 1985;42(1):15.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In view of the recent controversy in these columns concerning the presence or absence of a CNS lesion in Miller-Fisher syndrome,^1-3 I call the attention of interested readers' to the first report of an archetypal case that had no abnormalities in the brain stem at necropsy⁴. All the "central" signs were associated only with peripheral nerve demyelination and inflammation.

Patients with drowsiness, other ture brain-stem signs, and Babinski's signs, in addition to ataxia, ophthalmoplegia, and areflexia, are likely to have a brain-stem encephalitis. These patients can, and should be, distinguished clinically from those patients with the Miller-Fisher variant of Guillain-Barre syndrome, that is peripheral neuropathy. The ophthalmoplegia and ataxia suggest that there may be immunologic similarities between oculomotor nerves and certain (?spinocerebellar) afferents in peripheral nerves. . . . [Full Text PDF of this Article]

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