• Neurology · Aug 2020

    Case Reports

    Miller Fisher syndrome and polyneuritis cranialis in COVID-19.

    • Consuelo Gutiérrez-Ortiz, Antonio Méndez-Guerrero, Sara Rodrigo-Rey, Eduardo San Pedro-Murillo, Laura Bermejo-Guerrero, Ricardo Gordo-Mañas, Fernando de Aragón-Gómez, and Julián Benito-León.
    • From the Departments of Glaucoma and Neuro-Ophthalmology (C.G.-O., S.R.-R., F.d.A.-G.) and Neurology (R.G.-M.), University Hospital "Príncipe de Asturias," Alcalá de Henares; Department of Glaucoma (C.G.-O.), "Martínez de Carneros" Clinic; Department of Neurology (A.M.-G., E.S.P.-M., L.B.-G., J.B.-L.), University Hospital "12 de Octubre"; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) (J.B.-L.); and the Department of Medicine (J.B.-L.), Universidad Complutense, Madrid, Spain.
    • Neurology. 2020 Aug 4; 95 (5): e601-e605.

    ObjectiveTo report 2 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented acutely with Miller Fisher syndrome and polyneuritis cranialis, respectively.MethodsPatient data were obtained from medical records from the University Hospital "Príncipe de Asturias," Alcalá de Henares, and the University Hospital "12 de Octubre," Madrid, Spain.ResultsA 50-year-old man presented with anosmia, ageusia, right internuclear ophthalmoparesis, right fascicular oculomotor palsy, ataxia, areflexia, albuminocytologic dissociation, and positive testing for anti-GD1b-immunoglobulin G antibody. Five days previously, he had developed a cough, malaise, headache, low back pain, and fever. A 39-year-old man presented with ageusia, bilateral abducens palsy, areflexia, and albuminocytologic dissociation. Three days previously, he had developed diarrhea, a low-grade fever, and poor general condition. Oropharyngeal swab test for SARS-CoV-2 by qualitative real-time reverse transcriptase PCR assay was positive in both patients and negative in the CSF. The first patient was treated with IV immunoglobulin and the second with acetaminophen. Two weeks later, both patients made a complete neurologic recovery, except for residual anosmia and ageusia in the first case.ConclusionsOur 2 cases highlight the rare occurrence of Miller Fisher syndrome and polyneuritis cranialis during the coronavirus disease 2019 (COVID-19) pandemic. These neurologic manifestations may occur because of an aberrant immune response to COVID-19. The full clinical spectrum of neurologic symptoms in patients with COVID-19 remains to be characterized.© 2020 American Academy of Neurology.

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