Miller Fisher Syndrome in the COVID-19 Era – A Novel Target Antigen Calls for Novel Treatment

SARS-CoV-2 associated Miller-Fisher syndrome or polyneuritis cranialis

“…Of these 11 patients, 2 patients had MFS plus PNC and one patient MFS plus acute, inflammatory demyelinating polyneuropathy (AIDP) (Finsterer et al 2021 ). In addition to these 11 cases, SARS-CoV-2-associated MFS was reported by Kajani et al ( 2021 ) and Manganotti et al ( 2020 ).…”

“…As per the end of March 2021 at least 13 patients with SARS-CoV-associated MFS or polyneuritis cranialis (PNC) have been reported (Dinkin et al 2020 , Garnero et al 2020 , Gutiérrez-Ortiz et al 2020 , Juliao Caamaño and Alonso 2020 , Kajani et al 2021 , Lantos et al 2020 , Lowery et al 2020 , Manganotti et al 2020 , Ray 2020 , Reyes-Bueno et al 2020 , Senel et al 2020 ). In a recent review about SARS-CoV-2 associated Guillain Barre syndrome (GBS) collected until the end of December 2020, 11 patients with MFS or PNC were identified (Finsterer et al 2021 ).…”

COVID-19 Induced Miller Fisher Syndrome Presenting With Autonomic Dysfunction: A Unique Case Report and Review of Literature

“…2 Among these, MFS has been expectedly reported on rare occasions (Table 1). 3,[5][6][7][8][9][10][11][12][13][14] In the six out of 12 reported cases, including the current one, the neurological symptoms started two weeks after the onset of first symptoms of COVID-19 and in the remaining, the gap was typically less than five days. 3,[5][6][7][8][9][10][11][12][13] Most the patients responded favourably to intravenous immunoglobulin with minimal or no persisting neurological deficits.…”

“…3,[5][6][7][8][9][10][11][12][13] Only one patient died unexpectedly. 14 Classical albumino-cytological dissociation in cerebrospinal fluid analysis was found in seven out of 12 cases, meanwhile in the rest of them, three had normal findings and, in two cases, it was not reported. 3,[5][6][7][8][9][10][11][12][13][14] Contrast-enhanced neuroimaging was available in 10 out of 12 cases; 5,6,[8][9][10][11]13,14 in three patients, cranial, peripheral nerve root or radicular thickening, suggestive of leptomeningeal invasion by the virus or immune mediated radiculitis, was found.…”

“…4 Amidst the spectrum of Guillain-Barré syndrome, only a few cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced Miller Fisher syndrome (MFS) have been reported. 3,[5][6][7][8][9][10][11][12][13][14] On the other hand, autonomic dysfunction preceding the development of full blown MFS is exceedingly rare, 15 unlike other variants of Guillain-Barré syndrome.…”