Miller Fisher Syndrome
A patient with no significant PMH presented with acute onset of diplopia associated with loss of balance 2 weeks after having an influenza infection. On examination: a bilateral limitation in adduction with end gaze nystagmus in the abducted eye was noted. Also, dilated and non-reactive pupils were noted. Initial laboratory results including CBC, CMP were found normal. CSF analysis showed normal proteins. MRI of the brain with contrast was unremarkable. EMG test performed 1 week after initial presentation showed: non-length dependent polyneuropathy with focal demyelination. Anti-GQ1B antibodies were found to be positive. Patient received 5 sessions of plasmapheresis with resolution of the symptoms.
Presentation Date: 04/18/2024
Issue Date: 04/26/2024
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