COVID-19 Presenting As Miller Fisher Syndrome in a Patient With a History of Guillain-Barré Syndrome: A Case Report

Aldabain, Louay; Haddaden, Metri; Farooqi, Rehan; Alissa, Malaz

doi:10.7759/cureus.26588

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…The number of reported cases in 2021 was five [7,9,31,32]. Seven cases were reported in 2022 [33][34][35][36][37][38][39]. The last reported case was a boy from Izmir, Turkey, reported in January 2023 [6].…”

Section: Discussionmentioning

confidence: 99%

Miller Fisher Syndrome Associated With COVID-19: A History of Molecular Mimicry and an Up-to-Date Review of the Literature

Poyraz¹

2023

Cureus

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Miller Fisher syndrome (MFS) was first recognized by Collier in 1932 as a clinical triad of ataxia, areflexia, and ophthalmoplegia. In 1956, three cases with this triad were published by Miller Fisher as a limited variant of Guillian-Barré syndrome (GBS), and the disease started to be called by his name. Since the beginning of the SARS-CoV-2 pandemic, there have been many reports of peripheral and central nervous system involvement. Until December 2022, a total of 24 cases, including four children associated with MFS, had been reported. This current review aimed to present the basic clinical and laboratory characteristics of patients with MFS and coronavirus disease-2019 (COVID-19). Since 2020, cases with different age and gender characteristics have been reported from eight different countries. Most cases were reported from Europe. SARS-CoV-2 infection was confirmed in seven of the cases. The youngest case reported was a 6-year-old boy from Turkey, while the oldest case was a 70-year-old female from Spain. All these reported cases and our past medical knowledge of MFS suggest that molecular mimicry is the main immunological mechanism. Despite all these data, more case reports, cohorts, and case-control studies will be needed to clarify the relationship between MFS and COVID-19.

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Section: Discussionmentioning

confidence: 99%

Miller Fisher Syndrome Associated With COVID-19: A History of Molecular Mimicry and an Up-to-Date Review of the Literature

Poyraz¹

2023

Cureus

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Miller Fisher Syndrome With Positive Anti-GQ1b/GQ1d Antibodies Associated With COVID-19 Infection: A Case Report

Abu-Abaa¹,

Jumaah²,

Mousa³

et al. 2023

Cureus

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The association between Guillain-Barré Syndrome (GBS) and its variants including Miller Fisher syndrome (MFS) has been reported and debated in the literature. Herein, we are reporting a 59-year-old male patient who had flu-like symptoms for 10 days prior to presentation with rapidly progressive weakness, dysphagia, and dysarthria. He tested positive for COVID-19 and further workup showed positive anti-GQ1b and GQ1d antibodies. The diagnosis of MFS was presumed and prompted the commencement of intravenous immunoglobulin (IVIG). Respiratory deterioration prompted intubation and failure of extubation necessitated plasmapheresis. This treatment culminated in successful extubation and discharge to a longterm care facility. This case adds to the currently limited body of cases that report the association of a rare GBS variant with COVID-19 infection. Only a few of the reported cases of COVID-19-related MFS cases had positive anti-GQ1b antibodies. This may well be the first reported case of COVID-19-related MFS with positive anti-GQ1b and anti-GQ1d antibodies.

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COVID-19 Presenting As Miller Fisher Syndrome in a Patient With a History of Guillain-Barré Syndrome: A Case Report

Cited by 2 publications

References 20 publications

Miller Fisher Syndrome Associated With COVID-19: A History of Molecular Mimicry and an Up-to-Date Review of the Literature

Miller Fisher Syndrome Associated With COVID-19: A History of Molecular Mimicry and an Up-to-Date Review of the Literature

Miller Fisher Syndrome With Positive Anti-GQ1b/GQ1d Antibodies Associated With COVID-19 Infection: A Case Report

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