- Miller Fisher test
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The Miller Fisher test is a diagnostic procedure used to confirm suspected normal pressure hydrocephalus (NPH). The Miller Fisher test confirms NPH if the removal of 30 mL of cerebrospinal fluid (CSF) results in clinical improvement of NPH symptoms.
Diagnosis of NPH is usually first led by a lumbar puncture, followed by the evaluation of clinical response to removal of CSF. This can be followed by a CT, MRI, and continuous external lumbar CSF drainage during 3 or 4 days.
Lumbar puncture is usually the first step in diagnosis of NPH and the opening pressure measured carefully. In most cases, CSF pressure is usually above 155 mmH2O. Clinical improvement after removal of CSF (30 mL or more) has a high predictive value for subsequent success with shunting. This is called the "lumbar tap test" or "Miller Fisher test". A "negative" test has a very low predictive accuracy, as many patients may improve after a shunt in spite of lack of improvement after CSF removal.
History
Described by neurologist, Charles Miller Fisher.
Eponymous medical signs · nervous system CNS Head, generalBattle's sign · Broca aphasia · Kernig's sign · Macewen's sign · Myerson's sign · Stroop test · Wada test · Dix-Hallpike test · Hirano bodyOtherPNS CombinationLower limbUpper limbOther torso/limbsUpper limbLower limbAbadie's sign of tabes dorsalis · Gowers' sign · Hoover's sign · Lasègue's sign · Trendelenburg's signTorsoGeneralTodd's paresis · Jolly's testMental/behavioral Categories:- Medical tests
- Symptoms and signs: Nervous system
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