Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically presents with respiratory illness and fever, however some rare neurologic symptoms have been described as presenting complaints. We report a case of an acute motor and sensory polyneuropathy consistent with Miller-Fisher Syndrome (MFS) variant of Guillain Barre Syndrome (GBS) as the initial symptom. Case Report A 31-year old Spanish speaking male presents with two months of progressive weakness, numbness, and difficult walking. He had multiple cranial nerve abnormalities, dysmetria, ataxia, and absent lower extremity reflexes. An extensive workup including infectious, autoimmune, paraneoplastic, metabolic and neurologic testing was performed. Initially SARS-CoV-2 was not suspected based on a lack of respiratory symptoms. However, workup revealed a positive SARS-CoV-2 polymerase chain reaction test as well as presence of Anti-Ganglioside – GQ1b (Anti-GQ1b) immunoglobulin G antibodies. Discussion Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome (GBS) characterized by a triad of ophthalmoplegia, ataxia, and areflexia. The patient’s exam and workup including Anti-GQ1b is consistent with MFS. Conclusion SARS-CoV-2 infection in patients can have atypical presentations similar to this neurologic presentation. Prompt recognition and diagnosis can minimize the risk of transmission to hospital staff and facilitate initiation of treatment.
【저자키워드】 COVID-19, SARS-CoV-2, COVID, Guillain-Barré syndrome, Miller fisher syndrome, motor and sensory polyneuropathy, 【초록키워드】 antibodies, coronavirus, SARS-COV-2 infection, variant, Diagnosis, Respiratory illness, Symptom, Hospital staff, Immunoglobulin, Fever, male, Patient, Autoimmune, Guillain-barrè syndrome, Atypical, respiratory symptoms, Ataxia, initial symptom, acute respiratory syndrome, Abnormalities, weakness, report, positive, Spanish, neurologic, risk of transmission, polymerase chain, described, lack, was performed, facilitate, characterized, presenting, cranial, Initially, initiation of treatment, 【제목키워드】 Polyneuropathy, report, motor, Sensory,