CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1575696
Miller-Fisher syndrome presenting with headache and ophthalmoparesis: a case report and literature review
Provisionally accepted
- Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Miller-Fisher syndrome (MFS) is a rare variant of Guillain-Barre syndrome, classically characterized by a triad of symptoms, including ataxia, areflexia, and ophthalmoplegia. However, only a few cases have documented clinical data on a rare atypical presentation of MFS, with headache and ophthalmoplegia as the initial manifestation. We report an 83-year-old Chinese female patient with no history of respiratory or gastrointestinal infection presented with headache and ophthalmoplegia. Cerebrospinal fluid analysis showed albuminocytological dissociation, along with positive anti-GQ1b antibodies, leading to a diagnosis of incomplete Miller-Fisher syndrome.The patient's headache symptoms were relieved following immunoglobulin treatment, and ophthalmoplegia resolved within 20 days. A literature search identified eight cases of MFS patients initially presenting with headaches, followed by ophthalmoplegia. Detection of anti-ganglioside antibodies in serum or cerebrospinal fluid enables early diagnosis of MFS, and early immunoglobulin treatment improves patient prognosis.
Keywords: Headache, Ophthalmoplegia, Miller-Fisher syndrome, case report, literature review
Received: 25 Feb 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Huang, Lin, Huang and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xuerong Huang, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Xiaoxiao Yan, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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