Seronegative Miller–Fisher syndrome with bulbar palsy – reference to the spectrum of autoimmune neuropathies with the presence of antiganglioside antibodies. A case report

Agnieszka Meller, Monika Gołąb-Janowska, Zofia Osuch, Michał Maj, Przemysław Nowacki



Introduction: Miller–Fisher syndrome is rare variant of acute inflammatory demyelinating polyradiculoneuropathy consisting of a clinical triad – ophthalmoplegia, ataxia and areflexia.

Case report: We present a case of uncommon clinical manifestations, which were dysarthic speech and dysphagia caused by soft palate paresis. These were preceded by problems with balance, impaired vision and numbness in the upper limbs. Blood serum was negative for anti-GQ1b immunoglobulin G antibodies. The patient received a total of 5 cycles of plasmapheresis. On day 16 of hospitalization the patient showed diminished ataxia symptoms as well as improvement in eyeball mobility and gait. A scheduled check-up 8 weeks after leaving the hospital showed complete recovery from neurological deficit.


Miller–Fisher syndrome; polyradiculoneuropathy; autoimmune disease; anti-GQ1b antibodies; dysphagia

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