A friend of mine approached me last year, to look into a condition of 
trigeminal neuralgia, a condition his mother had been diagnosed with. It 
happens that his mom has celiac disease, an area in which I am very 

The above post reminded me that Miller-Fisher syndrome (MFS) has been 
identified as a variant of Guillain-Barre syndrome. Farah et. al. (1)  
and others have connected this syndrome with opthalmic division of the 
trigeminal nerve. MFS is a demyelinating neuropathy, which presents in 
cycles of opthalmoplegia, areflexia, and ataxia (2). Willison & Veach 
have identified circulating IgG antibodies to carbohydrate determinants in 
the blood of acute phase MFS patients (3). 

The latter researchers argue for GQ1b antibodies as the resulting from a 
dynamic that appears to be what is characterized by others as molecular 
mimicry. They suggest that an unidentified glycoprotein antigen with 
carbohydrate determinants is at the root of this autoimmune attack on the 
nerves in question. 

Hughes, on the other hand, identifies a variability in the autoantigen 

Through MRI, Urushitani et. al. have established a clear connection 
between spinocerebellar lesions, and cerebellar ataxia, but they express 
less certainty of the case examined as MFS (4).

It may surprise some of those who monitor this newsgroup to hear that I 
believe that MFS is one manifestation of neuropathic celiac disease which
has been defined separately due to the low level of clinical suspicion 
for celiac disease.

Ron Hoggan


1. Farah et. al. "Miller Fisher syndrome: unique involvement of opthalmic 
division of trigeminal nerve" Clin Neurol Neurosurg 1995; 97(4): 328-331

2. Hughes, RA "The spectrum of acquired demyelinating 
polyradiculoneuropathy" Acta Neurol Belg 1994; 94(2): 128-132

3. Willison & Veitch "Immunoglobulin subclass distribution and binding 
characteristics of anti-GQ1b antibodies in Miller Fisher syndrome" J 
Neuroimmunol 1994; 50(2): 159-165 

4. Urushitani et. al. "Miller Fisher-Guillain-Barre overlap syndrome with 
enhancing lesions in the spinocerebellar tracts" J Neurol Neurosurg 
Psychiatry 1995; 58(2): 241-243