Miller Fisher syndrome(MFS)is a clinical variant of Guillain-Barre syndrome(GBS)and has the main clinical features of ataxia,ophthalmoplegia,and tendon areflexia,with pupil changes and abnormal pupillary light reflex in rare cases.There are generally no symptom fluctuations,and positive anti-GQ1b IgG antibodies can be detected in some patients.This article reports a case of MFS with positive anti-GQ1b,anti-GT1a,and anti-sulfatide antibodies and fluctuating extraocular muscle paralysis as the initial presentation,accompanied by bilateral pupil dilation,delayed light reflex,and numbness and weakness in the limbs.The symptoms are rare and atypical,which may easily lead to misdiagno-sis in clinical practice.
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