Proximal conduction abnormality of the facial nerve in Miller Fisher syndrome: a study using transcranial magnetic stimulation

Case Report and Literature Analysis: Guillain-Barré Syndrome With Delayed Unilateral Facial Palsy

Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy in which most patients have cranial nerve involvement, with facial nerve involvement being the most common. However, delayed facial palsy (DFP) with asymmetric facial palsy is a rare manifestation of GBS, and the mechanism is unclear. We report a case of GBS combined with delayed unilateral facial palsy and review previously reported cases of GBS combined with DFP. A total of 28 cases of GBS with DFP, including the case in this report, were included in this study. The occurrence of DFP may be related to early subclinical demyelination of the facial nerve, the blood-nerve barrier of the facial nerve, facial movement, and descending reversible paralysis. The occurrence of unilateral facial palsy may be related to Campylobacter jejuni, specific anti-ganglioside antibodies, and the site of central nervous system anatomical involvement. There is no evidence that immunotherapy is related to the shortening of DFP course and improving patients' prognosis.

Delayed facial palsy in Miller Fisher syndrome

Miller Fisher syndrome is characterised by the triad of ophthalmoplegia, ataxia and areflexia. However, facial palsy can occur during the course of the illness although development of facial palsy when other cardinal signs of Miller Fisher syndrome have reached nadir or improving, is unusual. This delayed appearance of facial palsy can be easily overlooked by the treating clinician. Here, we report four patients with Miller Fisher syndrome and delayed-onset facial palsy. We discuss the possible underlying reasons behind the delay in facial palsy.

Micro-multi-probe electrode array to measure neural signals

A multi-electrode array (MEA) with 16 channels was designed to record simultaneously the velocity of conduction of neurons in a measurement system for bio-medical applications. MEA were fabricated with MEMS technology on a silicon-on-insulator (SOI) wafer, which controls the thickness of the probe effectively. All used probes have length 3mm and width 100mum. The thickness of the probe, 25mum, was defined by the thickness of the device layer on the SOI wafer. The multiple probes with a 16-site recording electrode array have been manufactured; their strength was tested with a force gauge and their electrical performance was tested with an impedance measurement system. The readout circuitry comprises an array of 16-site preamplifiers fully integrated on a chip that is capable of signal processing to improve the signal-noise-ratio (SNR). To demonstrate the capability, multiple neural signals were recorded simultaneously with all electrodes from each separate probe. To verify its capability of measuring neural signals, the MEA was used to measure these signals from the electrophysiology system of crayfish. The velocity of neural conduction recorded with a fabricated MEA is shown, and is comparable with a measurement with a traditional glass pipette. The MEA for recording neural signals would be improved in further development.