{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:29:13Z","timestamp":1785151753336,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Miller\u2212Fisher syndrome (MFS) is a recognized clinical variant of Guillain\u2212Barr\u00e9 syndrome (GBS), characterized by the classic triad of ophthalmoplegia, ataxia, and areflexia. When accompanied by additional symptoms such as bulbar palsy, limb weakness, or lethargy, it is termed MFS overlap syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>This report describes a male patient diagnosed with MFS overlap syndrome, presenting with ophthalmoplegia, ataxia, bulbar palsy, numbness in both arms, positive GM4 IgG antibodies, a persistent, intractable headache, and a delayed onset of left\u2010sided peripheral facial palsy. The patient had a preceding suspected case of chlamydial pneumonia before symptom onset, and his condition improved significantly following treatment with intravenous immunoglobulin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that chlamydial pneumonia might predispose individuals to GBS. Patients with MFS\/pharyngeal\u2010cervical\u2010brachial (PCB) overlap syndrome may exhibit atypical symptoms, including persistent, intractable headaches, and delayed peripheral facial paralysis. Atypical symptoms should not delay the diagnosis and treatment of GBS once other conditions have been adequately excluded. The presence of anti\u2010GM4 antibodies, often found alongside other anti\u2010ganglioside antibodies, may serve as a critical immunological factor in MFS\/PCB overlap syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70280","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:22:54Z","timestamp":1760556174000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Miller\u2212Fisher Overlap Syndrome With Positive Anti\u2010GM4 Antibody and Atypical Symptoms"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4012-4457","authenticated-orcid":false,"given":"Miao","family":"Tang","sequence":"first","affiliation":[{"name":"College of Clinical Medicine Hunan University of Chinese Medicine Changsha Hunan China"},{"name":"Department of Neurology The Second People's Hospital of Hunan Province (Brain Hospital of Hunan Province) Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8303-7866","authenticated-orcid":false,"given":"Runhong","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology The Second People's Hospital of Hunan Province (Brain Hospital of Hunan Province) Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Xu","sequence":"additional","affiliation":[{"name":"Xiangtan Yuetang District Hetang Neighbourhood Community Health Service Center Xiangtan Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine Hunan University of Chinese Medicine Changsha Hunan China"},{"name":"Department of Neurology The Second People's Hospital of Hunan Province (Brain Hospital of Hunan Province) Changsha Hunan 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