Guillain\u2013Barr\xe9/Miller Fisher overlap syndrome in a patient after coronavirus disease-2019 infection: a case report

Seyede Momeneh Mohammadi,Fatemeh Mortazavi,Zeinab Karimi,Roghayeh Abdi

doi:10.1186/s13256-021-03245-y

Abstract

BackgroundBeyond the typical respiratory symptoms associated with novel coronavirus, increasing evidence has been reported of the neurological manifestations affecting both the central and peripheral nervous systems.Case presentationWe observed a 30-year-old Persian woman developing acute motor sensory axonal neuropathy, a variant of Guillain–Barré syndrome that overlaps Miller Fisher syndrome, 30 days after confirmed coronavirus disease-2019 infection. Our case highlight the rare occurrence of Guillain–Barré syndrome overlapping with Miller Fisher during the coronavirus disease-2019 pandemic. These neurologic manifestations may occur because of an aberrant immune response to coronavirus disease-2019.ConclusionsThe early recognition of Guillain–Barré syndrome symptoms is critical, given the associated severe motor disabilities that may seriously limit the quality of life of these patients. We may still have much to learn about the co-occurrence of Guillain–Barré syndrome and Miller Fisher to improve the quality of life of these patients requiring an accurate evaluation by neurologists.

Highlights

A new coronavirus, the severe acute respiratory distress syndrome–coronavirus-2 (SARS-CoV-2/ COVID-19), has spread fast throughout the world, leading to high morbidity and mortality [1]
The early recognition of Guillain–Barré syndrome symptoms is critical, given the associated severe motor disabilities that may seriously limit the quality of life of these patients
We may still have much to learn about the co-occurrence of Guillain–Barré syndrome and Miller Fisher to improve the quality of life of these patients requiring an accurate evaluation by neurologists

Summary

Conclusions

This case highlights several neurological and medical complications from COVID-19-provoked GBS, including AMSAN. Our case should be considered as a variant of GBS (the overlap with MFS), which demonstrated an excellent response to immunoglobulin treatment, suggesting the immune-mediated nature of neuropathy. There should be a high suspicion for MFS when the presentation involves ataxia, areflexia, and ophthalmoplegia since MFS is a rare and poorly understood condition. Treatment with intravenous immunoglobulin can accelerate recovery and improve clinical outcomes. The early recognition of GBS symptoms is critical, given the associated severe motor disabilities that may seriously limit quality of life and requires an accurate evaluation by neurologists

Introduction

Discussion