• Xiubin Liu, Xiqi Chen, Yongkun Zhou, and Xiaoxia Zhang.
• Shandong Institute of Literature and Culture, Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, People's Republic of China.
• Medicine (Baltimore). 2022 Sep 9; 101 (36): e30434e30434.

IntroductionMiller Fisher syndrome (MFS), regarded by many scholars as a variant of Guillain Barre syndrome (GBS), accounts for approximately 5% to 10% of GBS cases. The typical clinical manifestations of MFS are extraocular muscle paralysis, ataxia, and tendon reflex loss or disappearance. To date, intestinal obstruction has rarely been reported as the initial symptom.Patient ConcernsA 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-ganglioside antibodies.DiagnosisThe patient was diagnosed as MFS.InterventionsThe early stage is mainly symptomatic treatment of paralytic ileus. After MFS was diagnosed, the patient was given large amounts of immunoglobulin and hormone shock therapy.OutcomesAfter 1 week, the symptoms of intestinal obstruction and MFS gradually improved. The patient was later discharged automatically for financial reasons. Six months after discharge, the patient was interviewed by telephone, and she had recovered.ConclusionTo date, intestinal obstruction has rarely been reported as the initial symptom. In case of inconsistencies between the imaging examinations and clinical symptoms, neuroelectrophysiology and cerebrospinal fluid puncture should be performed, striving for timely detection and treatment.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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