{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:40:22Z","timestamp":1794220822883,"version":"4.8.0"},"reference-count":52,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2014,8,25]]},"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>Guillain\u2013Barr\u00e9 syndrome (GBS) and its variant, Miller Fisher syndrome (MFS) have several subtypes, together forming a continuous spectrum of discrete and overlapping syndromes. Such is the heterogeneity within this spectrum that many physicians may be surprised to learn that these disorders are related pathophysiologically, and therefore share certain clinical features. These include history of antecedent infection, monophasic disease course and symmetrical cranial or limb weakness. The presence of cerebrospinal fluid albuminocytological dissociation (raised protein, normal cell count), antiganglioside antibodies and neurophysiological evidence of axonal or demyelinating neuropathy also support a diagnosis in many cases, but should not be relied upon. Mimics of GBS and MFS can broadly be divided into those presenting with symmetrical limb weakness and those presenting with brainstem signs. MFS and the pharyngeal-cervical-brachial variant of GBS are frequently mistaken for brainstem stroke, botulism or myasthenia gravis, whereas Bickerstaff's brainstem encephalitis is often diagnosed as Wernicke's encephalopathy. Chameleons or atypical presentations of GBS-related disorders include: paraparetic GBS, bifacial weakness with paraesthesias, acute ataxic neuropathy, acute ophthalmoparesis, acute ptosis and acute mydriasis. Many neurologists may also not be aware that deep tendon reflexes remain present or may even appear brisk in up to 10% of patients with GBS. Correct diagnosis of GBS-related disorders helps to avoid unnecessary investigations and allows early immunotherapy if appropriate.<\/jats:p>","DOI":"10.1136\/practneurol-2014-000937","type":"journal-article","created":{"date-parts":[[2014,9,20]],"date-time":"2014-09-20T01:08:54Z","timestamp":1411175334000},"page":"90-99","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":134,"title":["Mimics and chameleons in Guillain\u2013Barr\u00e9 and Miller Fisher syndromes"],"prefix":"10.1136","volume":"15","author":[{"given":"Benjamin R","family":"Wakerley","sequence":"first","affiliation":[{"name":"Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Yuki","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Physiology, Yon Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,9,19]]},"reference":[{"key":"2025090410455068000_15.2.90.1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1038\/nrneurol.2014.138","article-title":"Guillain-Barr\u00e9 and Miller Fisher syndromes \u2013 new diagnostic classification","volume":"10","author":"Wakerley","year":"2014","journal-title":"Nat Rev Neurol"},{"key":"2025090410455068000_15.2.90.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6330-4"},{"key":"2025090410455068000_15.2.90.3","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt285"},{"key":"2025090410455068000_15.2.90.4","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.8.1104"},{"key":"2025090410455068000_15.2.90.5","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-305397"},{"key":"2025090410455068000_15.2.90.6","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1994.00540190051014"},{"key":"2025090410455068000_15.2.90.7","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/ncn3.59","article-title":"Paraparetic Guillain-Barr\u00e9 syndrome: extending the axonal spectrum","volume":"1","author":"Nagashima","year":"2013","journal-title":"Neurol Clin Neurosci"},{"key":"2025090410455068000_15.2.90.8","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1212\/WNL.0000000000000481","article-title":"Paraparetic Guillain-Barr\u00e9 syndrome","volume":"82","author":"van den Berg","year":"2014","journal-title":"Neurology"},{"key":"2025090410455068000_15.2.90.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5254-8"},{"key":"2025090410455068000_15.2.90.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM195607122550201"},{"key":"2025090410455068000_15.2.90.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5032.1384"},{"key":"2025090410455068000_15.2.90.12","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2001.103005278.x"},{"key":"2025090410455068000_15.2.90.13","doi-asserted-by":"crossref","first-page":"545","DOI":"10.3329\/jhpn.v28i6.6602","article-title":"Quantifying the association between Campylobacter infection and Guillain-Barr\u00e9 syndrome: a systematic review","volume":"28","author":"Poropatich","year":"2010","journal-title":"J Health Popul Nutr"},{"key":"2025090410455068000_15.2.90.14","doi-asserted-by":"publisher","DOI":"10.1086\/513783"},{"key":"2025090410455068000_15.2.90.15","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.1.335-339.2005"},{"key":"2025090410455068000_15.2.90.16","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1586\/1744666X.2013.811119","article-title":"Infectious and noninfectious triggers in Guillain-Barr\u00e9 syndrome","volume":"9","author":"Wakerley","year":"2013","journal-title":"Expert Rev Clin Immunol"},{"key":"2025090410455068000_15.2.90.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199204233261706"},{"key":"2025090410455068000_15.2.90.18","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.222836"},{"key":"2025090410455068000_15.2.90.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(00)00420-6"},{"key":"2025090410455068000_15.2.90.20","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1212\/WNL.51.5.1515-b","article-title":"Isolated internal ophthalmoplegia associated with immunoglobulin G anti-GQ1b antibody","volume":"51","author":"Yuki","year":"1998","journal-title":"Neurology"},{"key":"2025090410455068000_15.2.90.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2009.07.008"},{"key":"2025090410455068000_15.2.90.22","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.156463"},{"key":"2025090410455068000_15.2.90.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.06.003"},{"key":"2025090410455068000_15.2.90.24","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000167549.09664.b8"},{"key":"2025090410455068000_15.2.90.25","doi-asserted-by":"crossref","unstructured":"Hughes RA Swan AV van Doorn PA . 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