What is the clinical utility of getting repeat antibody testing in patients with recurrent symptoms and a history of Miller-Fischer syndrome?

The treatment of MFS is controversial and not addressed in the recently published guidelines. Should a patient exhibit muscle weakness beyond facial and EOM, it could imply an overlap between MFS and/or GBS. While there's limited study in this area, persistent antibodies, albeit reduced, might not signify active disease. A significant titer increase could suggest a relapse but not conclusively diagnose it.

Many experts in GBS often refrain from treating MFS, given its excellent prognosis within s...

Recurrence of Miller-Fisher syndrome is exceptionally rare, and I only became aware of this possibility until I retrieved some relevant literature. Given its extreme rarity, and noting that the documented recurrences were primarily identified based on clinical features rather than antibody measurements alone, I would consider retreatment only for patients exhibiting recurrent cranial neuropathy (not limited to ophthalmoplegia), areflexia, and/or ataxia. I wouldn't recommend retreatment for patie...