Multiple sclerosis, Graves' ophthalmopathy, Miller-Fisher syndrome
, mitochondrial diseases, oculopharyngeal muscular dystrophy, vascular causes, and tumors were considered in the differential diagnosis.
is another variant of GBS that is an autoimmune reaction with antibodies present against gangliosides GD3, Gt1a, and GQ1B [8, 9, 12,15,17,18] with GQ1B being of particular clinical diagnostic significance as 90% of patients with Miller-Fisher syndrome
will have a positive serology for GQ1B antibody .
Two patients exhibited acute inflammatory demyelinating polyradiculoneuropathy: 1 had GBS, and 1 had Miller-Fisher syndrome
. Patient 14, a 60-year-old woman, was hospitalized for GBS.
The Miller-Fisher syndrome
is typically rare and presents with a classic triad of symptoms, which include ataxia, areflexia, and opthalmoplegia.
, a rare variant of GBS that typically presents with the classic triad of ataxia, areflexia and ophthalmoplegia should always be suspected in such presentations (13).
Cases were defined using diagnostic criteria for GBS formulated by the United States National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) , augmented firstly by the inclusion of patients with reduced rather than absent reflexes when accompanied by electrophysiological evidence suggesting demyelinating neuropathy, as in a recent clinical study , and secondly by including patients with the Miller-Fisher syndrome
(ophthalmoplegia, ataxia, and areflexia)  without limb weakness, as suggested by Asbury .
Patients with CSF pleocytosis, exposure to neurotoxins, or hereditary neuropathy were excluded, as were those with Miller-Fisher syndrome
. Age, sex, duration of symptoms, antecedents (classified as: absent, upper respiratory tract infection, acute gastroenteritis, vaccination, lower respiratory tract infection, mumps, rash, other), distribution of weakness at onset (flaccid paresis, tetraparesis, and bulbar involvement), presence of pain, sphincter dysfunction, cranial nerve involvement, CSF findings, electrophysiological findings, duration of hospitalization, requirement of ventilation, and treatment were recorded.