Abstract
Miller Fisher syndrome (MFS) is a rare immune-mediated neuropathy that often presents
with diplopia and bilateral external ophthalmoplegia. Other neurological deficits
may occur such as ataxia and areflexia but not in all cases. Although MFS is a clinical
diagnosis, serological confirmation is possible by identifying the anti-GQ1b antibody
found in the majority of patients. Myasthenia gravis is an autoimmune disorder of
the availability of acetylcholine receptors in the neuromuscular junction. Ocular
myasthenia gravis is a disease subtype characterized by variable patterns of weakness
of extraocular muscles, eyelid elevator, and orbicular muscle in which the initial
sign in most adults and children is ptosis. We report a child with MFS who presented
with clinical signs suggestive of ocular myasthenia gravis, but in whom the correct
diagnosis was made on the basis of serological testing for the anti-GQ1b antibody.
We aim to highlight the similarity between the two rare conditions and address the
importance of early liaison with neurologists and ophthalmologists in reaching to
the proper diagnosis.
Keywords
miller fisher syndrome - myasthenia gravis - ocular myasthenia gravis
