Paralytic Ileus as First Symptom of Miller Fisher Syndrome: a Case Report

Abstract Introduction Miller Fisher syndrome (MFS) is a nervous disease, immune correlation of Guillain Barre syndrome (GBS).The typical clinical manifestations of MFS are extraocular muscle paralysis, ataxia, tendon reflex loss or disappearance. This report describes a case of MFS with paralytic ileus as the first symptom. Case presentation A 48-year-old woman presenting with abdominal pain and distention was diagnosed with paralytic ileus. There was no significant improvement in symptoms after symptomatic treatment. After that, the patient developed visual rotation, with limited binocular abduction and adduction, and ataxia. Anti-ganglioside testing revealed positive anti-GQ1b antibodies. The patient was diagnosed as Miller Fisher syndrome. And recovered after symptomatic treatment. Conclusion In case of inconsistency between imaging examination and clinical symptoms, neuroelectrophysiology and cerebrospinal fluid puncture should be performed in time, and strive for timely detection and treatment.