Miller Fisher Variant of Guillain Barre Syndrome
A patient presents to the Bascom Palmer Emergency Room complaining of about 10-14 days of right upper eyelid droop, right eye pain, and new onset double vision. Past medical history is remarkable for hyperlipidemia, and two episodes of self-resolving cranial nerve VI palsies of the right and left eye. Patient reports recent nausea and vomiting 2 days prior to symptom onset. Ocular vital signs are within normal limits. Exam is remarkable for right upper lid ptosis, right hypertropia and right exotropia. Bilateral difficulty with adduction was also noted. Given bilateral internuclear ophthalmoplegia and recent suspected viral GI illness, suspicion for Miller-Fisher Variant of Guillaine- Barre Syndrome was high. Lab work was remarkable for high titers to anti-GQ1b. Togther, a diagnosis of incomplete Miller-Fisher Syndrome was made. The patient was observed off therapy with complete resolution of symptoms within 1 month of presentation.
Presentation Date: 08/20/2026
Issue Date: 08/21/2026
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