Fisher syndrome is characterized by ophthalmoplegia, ataxia and areflexia after preceding infection. The ophthalmoplegic symptom is described in a volume of Yomeibyo of the Shokan Ron, the classic Chinese encyclopedia of medical treatment. The Shokan Ron recommends Dai-joki-to as a treatment for this symptom. Accordingly, we administered Dai-joki-to to one patient diagnosed with atypical Fisher syndrome. The result was a prompt reduction of the ophthalmoplegic symptom in the patient. As Fisher syndrome is not a critical disease, Dai-joki-to administration should be considered as an alternative treatment to plasmapheresis.

To evaluate peripheral occlusive diseases quantitatively, we performed color duplex sonography. Between July 1996 and July 1998, we examined 68 limbs of 40 patients using color duplex sonography in addition to intraarterial digital subtraction angiography for evaluation of peripheral arterial occlusive disease. We classified the wave form of blood flow into four types (Type I-IV). Furthermore we measured the systolic velocities of the dorsal pedial and the posterior tibial arteries as well as the brachial artery. We also calculated the flow volume, and the ratio of systolic velocities and flow volume of lower to upper extremity (AVI, AFI). The waveform was significantly higher in Fontaine class III and IV, and showed remarkable improvement after arterial reconstruction. The value of AVI as well as AFI showed lower in Fontaine class I, II, III, and IV in order. In four limbs classified as Fontaine class II or more with normal ankle pressure index, the values of AVI were rather lower. On the other hand, three limbs with normal values of peak AVI (>0.9) and lower API (<0.75) were in Fontaine class I. The types of waveform correlated with clinical symptoms, and showed a remarkable regression after arterial reconstruction. The new AVI and AFI values had better correlation with clinical symptoms than API.