COVID-19 Presenting As Miller Fisher Syndrome in a Patient With a History of Guillain-Barré Syndrome: A Case Report

Abstract

Coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, primarily affects the respiratory system. While coronaviruses are not a common cause of neurological disease, they have been reported to cause direct central nervous system infection, as well as presumed para-infectious disorders. Here we report a very rare case of SARS-CoV-2 infection presenting as Miller Fisher syndrome with positive anti-GQ1b antibodies in a patient with a history of Guillain-Barré syndrome, which was treated with IV immunoglobulin resulting in marked improvement in her symptoms. Thus, a high index of suspicion and meticulous observation are the cornerstones to identifying possible uncommon presentations of COVID-19.

Keywords: anti gq1b antibodies; ataxia; covid-19; diplopia; miller fisher syndrome; ophthalmoplegia.