• Lisle Blackbourn, Umair Hamid, Janaki Tokala, and Gregory Blume.
• Department of Neurology, University of Illinois College of Medicine Peoria, Peoria, IL, USA.
• Medicine (Baltimore). 2024 May 24; 103 (21): e38304e38304.

RationaleMiller-Fisher syndrome (MFS) is a rare subtype of Guillain-Barre syndrome with classic features of ataxia, areflexia, and ophthalmoplegia that can be caused by a preceding infection including COVID-19. We present a current, asymptomatic thrombocytopenic COVID-19 infection as a cause of MFS in a 60-year-old male with a concurrent chronic immune neuropathy.Patient ConcernsA 60-year-old male presenting with acute symptoms of MFS including ataxia, areflexia, and ophthalmoplegia on a chronic immune neuropathy for at least 1 year and concurrent asymptomatic COVID-19 positive infection.DiagnosisMFS suspected secondary to a current thrombocytopenic COVID-19 infection.InterventionsFive days of intravenous immune globulin with continued monthly intravenous immune globulin as an outpatient, follow-up long-term in a neuromuscular clinic, electromyography as an outpatient, and continued physical therapy.OutcomesThe patient significantly improved after initial treatment.LessonsThe full effect of COVID-19 on the various Guillain-Barre syndrome subtypes is unknown, although it clearly can be a cause of the various variants including being caused by a current, asymptomatic infection.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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