FP112

PEERING INTO THE PUZZLE-MILLER FISHER VARIANT OF GUILLAIN BARRE SYNDROME WITH MILD PTOSIS

Purpose:To present Miller Fisher variant of GBS with mild ptosis as an atypical ocular manifestation
Method: A 74-year-old man with acute impairment of eye movements,bilateral eyelid drooping, walking difficulty,generalized weakness.Recent history of fever and cough.Clinical examination showed bilateral external ophthalmoplegia and mild ptosis.Neurological examination revealed limb weakness and loss of reflexes.
Results:Ophthalmic evaluation indicated reduced visual acuity and cataract with normal pupillary reflexes.NCS-sensory motor polyneuropathy,CSF analysis revealed albuminocytological dissociation.Anti-ganglioside antibody panel was negative.Patient was diagnosed with Miller Fisher variant of GBS and received IV immunoglobulin therapy resulting in gradual symptom improvement.
Conclusion:This emphasizes the importance of ophthalmic evaluation in diagnosing and treating Miller Fisher variant of GBS which can present with lid and pupillary abnormalities alongside classical features.