[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-460910-105":59,"doc-detail-460910-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","navigating-diagnostic-dilemmas-miller-fisher-syndrome-in-pregnancy-masquerading-as-stroke-a-case-report","Navigating Diagnostic Dilemmas: Miller Fisher Syndrome in Pregnancy Masquerading As Stroke - A Case Report","","Miller Fisher Syndrome (MFS) is a rare acquired demyelinating variant of Guillain-Barré Syndrome marked by acute ophthalmoplegia, ataxia, and areflexia. Higher incidence has been reported in Asian populations. In pregnancy, MFS may be misidentified as posterior circulation stroke because physiological changes and symptom overlap can obscure typical neurological signs. This case report describes a pregnant woman with acute binocular diplopia, dizziness, nausea, and vomiting, emphasizing early recognition and prompt treatment to improve outcomes.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/navigating-diagnostic-dilemmas-miller-fisher-syndrome-in-pregnancy-masquerading-as-stroke-a-case-report/460910/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/navigating-diagnostic-dilemmas-miller-fisher-syndrome-in-pregnancy-masquerading-as-stroke-a-case-report/460910.png","ImageObject",300,407,{"name":92,"@type":93},"Aria Callaghan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical features define Miller Fisher Syndrome (MFS)?","Question",{"text":113,"@type":114},"MFS is characterized by a triad of acute ophthalmoplegia, ataxia, and areflexia.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why can MFS be mistaken for stroke in pregnancy?",{"text":118,"@type":114},"An acute MFS presentation can mimic a posterior circulation stroke, and pregnancy-related physiological changes may obscure classical neurological signs. Imaging may also be limited by fetal safety considerations.",{"name":120,"@type":111,"acceptedAnswer":121},"What symptoms did the pregnant patient present with in the case report?",{"text":122,"@type":114},"The patient presented with sudden binocular diplopia, dizziness, nausea, and vomiting over 3 days.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},460910,1790928264,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962084926284,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Review began 11/21/2025  \nReview ended 12/06/2025  \nPublished 12/10/2025  \n© Copyright 2025  \nNadaraj. 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.98877  \nOpen Access Case Report  \nNavigating Diagnostic Dilemmas: Miller Fisher Syndrome in Pregnancy Masquerading As Stroke  \nKumutha Nadaraj 1  \n1. Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS Corresponding author: Kumutha Nadaraj, [nkumutha23@gmail.com](nkumutha23@gmail.com)  \nAbstract  \nMiller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS) characterized by a clinical triad of acute ophthalmoplegia, ataxia, and areflexia. Despite being a rare, acquired demyelinating nerve disease, a higher incidence has been reported among the Asian population, where the incidence is estimated to be 18-26% of GBS compared to 3-5% among the Western population. An acute presentation of MFS can mimic a posterior circulation stroke. Other differential diagnosis includes Wernicke’s encephalopathy (WE), which is characterized by a clinical triad of ophthalmoplegia, nystagmus, and ataxia. In this case report, we describe a pregnant lady who presented with an acute onset of binocular diplopia, dizziness, nausea, and vomiting. This case highlights the importance of early recognition of MFS features, the diagnostic challenges associated with it, and the significance of prompt treatment in improving clinical outcomes.  \nCategories: Neurology, Internal Medicine, Ophthalmology  \nKeywords: atypical gbs variant, miller fisher syndrome (mfs), ophthalmoplegia, pregnancy, rare neuroimmunological disorder  \nIntroduction  \nMiller Fisher syndrome (MFS) is an acute immune-mediated demyelinating polyneuropathy, first described by James Collier in 1932 as a triad of ophthalmoplegia, ataxia, and areflexia [1] . In 1956, Charles Miller Fisher classified it as a distinct entity within the Guillain-Barré Syndrome (GBS) spectrum [2] . MFS arises from an aberrant autoimmune response, often triggered by preceding upper respiratory or gastrointestinal infections. Molecular mimicry leads to the production of antibodies against gangliosides in peripheral nerves, causing demyelination and the characteristic clinical features [3] .  \nEpidemiologically, MFS is more common among Asian populations, accounting for 18-26% of GBS cases compared to 3-5% in Western populations [3,4] . Although contemporary population-based data in Malaysia are lacking, local studies suggest that while GBS occurs at rates comparable to global trends, MFS remains rare but documented [5] .  \nClinically, MFS can mimic a posterior circulation stroke due to the acute onset of ophthalmoplegia, ataxia, and associated nausea or vomiting. Pregnancy adds diagnostic complexity as physiological changes and pregnancy-associated symptoms can obscure classical neurological signs, and imaging modalities may be limited due to fetal safety considerations. Furthermore, in resource-limited settings, diagnosis often relies on detailed clinical assessment, basic laboratory tests, and cerebrospinal fluid analysis, rather than advanced neuroimaging or specialized antibody testing.  \nThis case report highlights the presentation, diagnosis, and management of a pregnant woman with MFS ina rural setting with limited resources, emphasizing the diagnostic challenges and clinical considerations in such contexts.  \nCase Presentation  \nWe report a 31-year-old Melanau lady, primigravida at 26 weeks of gestation, who presented to the Emergency Department with complaints of double vision, dizziness, nausea, and vomiting for 3 days. She reported that her double vision was sudden in onset, started upon waking up from sleep, and she had considerable difficulty walking due to dizziness and double vision. The","cbCais54e6BgiHoF","https://ap.wps.com/l/cbCais54e6BgiHoF","pdf",8196147,"English","# Abstract\n# Introduction\n# Case Presentation\n# How to cite this article","[{\"question\":\"What clinical features define Miller Fisher Syndrome (MFS)?\",\"answer\":\"MFS is characterized by a triad of acute ophthalmoplegia, ataxia, and areflexia.\"},{\"question\":\"Why can MFS be mistaken for stroke in pregnancy?\",\"answer\":\"An acute MFS presentation can mimic a posterior circulation stroke, and pregnancy-related physiological changes may obscure classical neurological signs. Imaging may also be limited by fetal safety considerations.\"},{\"question\":\"What symptoms did the pregnant patient present with in the case report?\",\"answer\":\"The patient presented with sudden binocular diplopia, dizziness, nausea, and vomiting over 3 days.\"}]","Navigating Diagnostic Dilemmas: Miller Fisher Syndrome in Pregnancy Masquerading As Stroke - A Case Report | PDF",1790760035,18]