Ophthalmoplegic and lower cranial nerve variants merge into each other and into classical Guillain-Barr� syndrome

Anti-GT1a IgG in Guillain-Barre syndrome

“…Patients with GBS, who initially had low cranial nerve involvement, showed a spread to ocular motor nerve involvement in 33% and facial nerve palsy in 85%. 2 Similarly, patients who initially showed oculomotor involvement often experienced the spread of weakness to the face and oropharynx. The common overlap of cranial nerve involvement in GBS is partially explained by the neurological manifestations of patients who have IgG antibodies that cross react with GT1a and GQ1b.…”

Guillain-Barré Syndrome and Related Disorders

“…Miller Fisher syndrome accounts for approximately 5 % of GBS cases in North America and Europe but may represent as high as 20-25 % of GBS patients in Eastern Asia [ 201,202 ] . In some patients, the illness progresses to generalized GBS that overtakes the other features [ 184,203 ] . Diplopia is usually the fi rst symptom, followed by limb or gait ataxia that appears within days.…”

“…This also helps distinguish this from the pharyngeal-cervical-brachial variant of GBS. Bilateral IX, X, and XI cranial nerve impairment, resulting in dysphagia, laryngopharyngeal discomfort, and slurred speech, is the initial symptom in most cases [ 203 ] . The second most common mode of presentation is facial nerve palsy, which is usually bilateral and of the peripheral type [ 223 ] .…”

Miller Fisher Syndrome – An Atypical Clinical Presentation

“…Recurrence of MFS also reported rarely [9]. Lower cranial nerve variants of GBS and atypical MFS were also reported [10].…”