Abstract
A 51-year-old woman presented with acute diplopia and was found to have ptosis and complete bilateral external and internal ophthalmoplegia. She had normal reflexes and gait. Serological testing showed elevated levels of GQ1b ganglioside autoantibodies, making the diagnosis of Miller Fisher syndrome. This case illustrates an atypical presentation of the Miller Fisher variant of Guillain-Barre syndrome, which should be considered in all patients presenting with bilateral ophthalmoplegia.
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