[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-418707-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-418707-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","miller-fisher-variant-of-guillain-barre-syndrome-presenting-with-dysphagia-and-ophthalmoplegia","Miller Fisher Variant of Guillain-Barré Syndrome Presenting With Dysphagia and Ophthalmoplegia","","Miller Fisher syndrome (MFS) is a rare Guillain-Barré syndrome (GBS) variant defined by ataxia, areflexia, and ophthalmoparesis. Triggered often by respiratory infection, it involves immune cross-activation against pathogenic proteins and gangliosides. Typical symptom sequence progresses from ophthalmoparesis to ataxia, then areflexia. This case highlights dysphagia and ophthalmoplegia as initial manifestations, emphasizing that combined dysphagia, ophthalmoplegia, areflexia, and ataxia should raise suspicion for MFS.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/miller-fisher-variant-of-guillain-barre-syndrome-presenting-with-dysphagia-and-ophthalmoplegia/418707/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/miller-fisher-variant-of-guillain-barre-syndrome-presenting-with-dysphagia-and-ophthalmoplegia/418707.png","ImageObject",300,407,{"name":42,"@type":43},"Alex Sinclair","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What defines Miller Fisher syndrome (MFS) as a Guillain-Barré syndrome variant?","Question",{"text":63,"@type":64},"MFS is characterized by a triad of ataxia, areflexia, and ophthalmoparesis. It is considered a rare variant of GBS with distinctive clinical features.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why is dysphagia an important warning sign in this case?",{"text":68,"@type":64},"The article notes only a limited number of reported MFS cases where dysphagia is an initial manifestation. When dysphagia occurs together with ophthalmoplegia, areflexia, and ataxia, suspicion for MFS should increase.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the diagnostic pathway begin for the patient described?",{"text":72,"@type":64},"The patient initially presented with dysphagia and ophthalmic symptoms, prompting evaluation for other conditions. Stroke imaging and other testing were negative, and the initial working diagnosis was myasthenia gravis before transfer for plasmapheresis.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},418707,1790740515,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":102,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},1099523882182,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review began 11/08/2025  \nReview ended 12/29/2025  \nPublished 01/02/2026  \n© Copyright 2026  \nSharma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.100614  \nOpen Access Case Report  \nMiller Fisher Variant of Guillain-Barré Syndrome Presenting With Dysphagia and Ophthalmoplegia  \nRupam Sharma 1, Sanjana Murdande 1, Jose Garcia-Corella 1, Arin Orogian 1, Linh Tran 1  \n1. Internal Medicine, University of California, Los Angeles (UCLA) Kern Medical, Bakersfield, USA Corresponding author: Sanjana Murdande, [sanjana.murdande@kernmedical.com](sanjana.murdande@kernmedical.com)  \nAbstract  \nMiller Fisher syndrome (MFS) is a rare variant of Guillain-Barré syndrome (GBS) . It is characterized by a triad of ataxia, areflexia, and ophthalmoparesis. Akin to GBS, it is often triggered by a respiratory infection, causing immune cross-activation against pathogenic proteins and gangliosides. Symptoms typically occur in chronological progression, beginning with ophthalmoparesis, then ataxia, and finally areflexia. Our case is of a patient presenting with dysphagia and ophthalmoplegia as the initial manifestations. There currently exist only a limited number of reported cases of MFS presenting with dysphagia, which, along with ophthalmoplegia, areflexia, and ataxia, should raise suspicion for MFS.  \nCategories: Neurology, Internal Medicine  \nKeywords: areflexia, dysphagia, gbs treatment, guillain-barre syndrome (gbs), miller fisher variant, ophthalmoplegia  \nIntroduction  \nGuillain-Barré syndrome (GBS) is a rare but potentially life-threatening autoimmune disorder characterized by acute peripheral neuropathy, often triggered by an infection. While the classic form of GBS typically presents with symmetric ascending muscle weakness and areflexia, several variants exist, each with distinct clinical features. One such variant is Miller Fisher syndrome (MFS), which is considered a specific form of GBS. It accounts for 1-5% of all GBS cases in Western countries [1] . MFS is characterized by the classical triad of ataxia, areflexia, and ophthalmoplegia, and it is often associated with anti-GQ1b antibodies, which are thought to play a crucial role in the pathogenesis of the disease. The localization of GQ1b antigens to the oculomotor nerve and muscle spindles is responsible for the characteristic features. The glossopharyngeal and vagus nerves may also express the GQ1b antigen, producing dysphagia in some patients [2,3] . However, only 2% of patients have been reported to present with dysphagia as the initial symptom, perhaps because the responsible nerves are less affected, which contributes to the diagnostic challenge [4] . Though MFS is rare, its recognition is important, as early diagnosis and appropriate treatment can significantly improve patient outcomes. Here is presented a unique case of a patient with the Miller Fisher variant of GBS presenting with severe dysphagia, which initially was thought to be myasthenia gravis.  \nCase Presentation  \nThe patient was a 35-year-old White male with a medical history of syphilis one year ago treated with penicillin at a public county hospital and gastric sleeve 10 years ago with resulting 100 pound weight  \nloss, who presented to the emergency department (ED) with chief complaint of dysphonia, blurry vision, weakness and numbness in arms and legs, and difficulty swallowing solids and liquids, which began suddenly one day prior to presentation. Upon presentation, stroke code was activated, and the patient underwent computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA) of the head, all of which resulted in negative findings. The respiratory BioFire test was negative as well. The patient was transferred to another hospital for higher-le","cbCaiiVTn5z1kVCc","https://ap.wps.com/l/cbCaiiVTn5z1kVCc","pdf",131170,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"What defines Miller Fisher syndrome (MFS) as a Guillain-Barré syndrome variant?\",\"answer\":\"MFS is characterized by a triad of ataxia, areflexia, and ophthalmoparesis. It is considered a rare variant of GBS with distinctive clinical features.\"},{\"question\":\"Why is dysphagia an important warning sign in this case?\",\"answer\":\"The article notes only a limited number of reported MFS cases where dysphagia is an initial manifestation. When dysphagia occurs together with ophthalmoplegia, areflexia, and ataxia, suspicion for MFS should increase.\"},{\"question\":\"How did the diagnostic pathway begin for the patient described?\",\"answer\":\"The patient initially presented with dysphagia and ophthalmic symptoms, prompting evaluation for other conditions. Stroke imaging and other testing were negative, and the initial working diagnosis was myasthenia gravis before transfer for plasmapheresis.\"}]","Miller Fisher Variant of Guillain-Barré Syndrome Presenting With Dysphagia and Ophthalmoplegia | PDF",1790614036,15]