Edvard Ehler, Leona Formanova, Alena Melekova, Petra Mandysova and Martin Valis
Background: Miller Fisher syndrome is a well-known disorder that belongs to a group of conditions with a high level of antibodies against ganglioside GQ1b. It is characterized by acute onset of ataxia, areflexia, and ophthalmoplegia. In cases of acute-onset ophthalmoplegia without ataxia, the diagnosis is more difficult; therefore, it is frequently delayed. Case Report: We report one such case of rapid onset of internal ophthalmoplegia, followed by external ophthalmoplegia. The diagnostic process was challenging, but eventually, a high level of antibodies against GQ1b confirmed the diagnosis. Because the clinical and electrophysiological findings were limited only to the presence of anti-GQ1b antibodies, a combination with a generalized form of Guillain-Barre syndrome could be excluded. Conclusion: Consequently, the patient was not treated with immunotherapy. At 4 months, the patient had made a good recovery.
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