Abstract
ObjectiveA rare variant Miller Fisher Syndrome overlap with Guillain Barre Syndrome is described in an adult patient with SARS-COV-2 infection.Case PresentationThe clinical course of a 45-year-old immunosuppressed man is summarized as a patient who developed ataxia, ophthalmoplegia, and areflexia after upper respiratory infection symptoms began. A nasopharyngeal swab was positive for COVID-19 polymerase chain reaction. He progressed to acute hypoxemic and hypercapnic respiratory failure requiring intubation and rapidly developed tetraparesis. Magnetic resonance imaging of the spine was consistent with Guillain Barre Syndrome. However, the clinical symptoms, along with positive anti-GQ1B antibodies, were consistent with Miller Fisher Syndrome and Guillain Barre Syndrome overlap. The patient required tracheostomy and had limited improvement in his significant neurological symptoms after several months.ConclusionsThe case demonstrates the severe neurological implications, prolonged recovery and implications in the concomitant respiratory failure of COVID-19 patients with neurological symptoms on the spectrum of disorders of Guillain Barre Syndrome.
Highlights
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) infection, has spread globally, with an increasing number of reported cases of critically ill patients with neurological complications [1]
Guillain Barre Syndrome is a generalized term for a heterogeneous group of polyradiculopathies associated with autoimmune responses to stressors with multiple different acute to subacute presentations
Acute inflammatory demyelinating polyradiculopathy (AIDP) is a common disorder in North America and is often most associated as part of the Guillain Barre Syndrome family of disorders [4]
Summary
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) infection, has spread globally, with an increasing number of reported cases of critically ill patients with neurological complications [1]. The case is presented of a COVID-19 infected patient initially presenting to the hospital with symptoms of Miller Fisher Syndrome, a variant of Guillain Barre Syndrome, characterized by areflexia, ataxia and ophthalmoplegia. The patient was positive for anti-GQ1B antibodies, typically seen in the Miller Fisher Syndrome variant of Guillain Barre.
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