Miller Fisher syndrome associated with respiratory failure

Miller Fischer syndrome (MFS) is a rare clinical variant of GuillainBarre syndrome. The diagnosis suspected primarily on clinical trial of areflexia, ophtalmoplegia and ataxia, is confirmed by the mandatory presence of antiganglioside antibodies (anti GQ1b). An acute onset is typical of MFS, beginning with neurological symptoms following a respiratory or digestive infectious illness. The therapeutic options are either the plasmapheresis or the administration of intravenous immunoglobulin (IVIG). Although rare, in certain cases the patients present with respiratory symptoms needing intensive care. We report the case report of a patient which presented with the classical triad of MFS but also with rapid progressive respiratory failure due to bilateral vocal cords palsy and general muscle weakness. He needed respiratory mechanical support. The patient received a treatment by IVIG without any improvement in symptomatology. Eventually he completely recovered and he was discharged from the hospital 3 month later