Case Report of Miller Fisher Syndrome a Variant of Guillain-Barre Syndrome

Miller Fisher syndrome (MFS), was first recognized by James Collier in 1932. MFS was named after Charles Miller Fisher who reported 3 cases of acute neurologic illnesses characterized by total external ophthalmoplegia, severe ataxia, and loss of tendon reflexes in 1956 as a limited variant of Guillain-Barré syndrome. MFS is mostly an acute, self-limiting condition. It is strongly associated with anti-GQ1b (antibody to ganglioside). MFS can be associated with infectious, autoimmune, and neoplastic disorders. Oculomotor dysfunction is partially explained by the tissue ganglioside concentration and distribution and the attraction of antibody-stimulating complement activation. Here, we present a case of a 25year old female patient who admitted with complaints of double vision that progressed to bilateral ophthalmoplegia, and ataxia with preceding gastro-intestinal infection. Subsequently she developed weakness of the all four extremities with proximal muscles affected more than distal muscles and areflexia. She was thoroughly investigated and is believed to have an axonal neuropathy in the form of Miller Fisher Syndrome (MFS) variant of GBS. She was initially treated with intravenous immunoglobulin, which significantly improved her symptoms.