{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T11:15:38Z","timestamp":1760267738137},"reference-count":6,"publisher":"California Digital Library (CDL)","issue":"3","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically presents with respiratory illness and fever, however some rare neurologic symptoms have been described as presenting complaints. We report a case of an acute motor and sensory polyneuropathy consistent with Miller-Fisher Syndrome (MFS) variant of Guillain Barre Syndrome (GBS) as the initial symptom.\n\nCase Report: A 31-year old Spanish speaking male presents with two months of progressive weakness, numbness, and difficult walking. He had multiple cranial nerve abnormalities, dysmetria, ataxia, and absent lower extremity reflexes. An extensive workup including infectious, autoimmune, paraneoplastic, metabolic and neurologic testing was performed. Initially SARS-CoV-2 was not suspected based on a lack of respiratory symptoms. However, workup revealed a positive SARS-CoV-2 polymerase chain reaction test as well as presence of Anti-Ganglioside \u2013 GQ1b (Anti-GQ1b) immunoglobulin G antibodies.\n\nDiscussion: Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome (GBS) characterized by a triad of ophthalmoplegia, ataxia, and areflexia. The patient\u2019s exam and workup including Anti-GQ1b is consistent with MFS.\n\nConclusion: SARS-CoV-2 infection in patients can have atypical presentations similar to this neurologic presentation. Prompt recognition and diagnosis can minimize the risk of transmission to hospital staff and facilitate initiation of treatment.<\/jats:p>","DOI":"10.5811\/cpcem.2020.6.48683","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T04:15:38Z","timestamp":1597205738000},"page":"352-354","source":"Crossref","is-referenced-by-count":17,"title":["A Case Report of Acute Motor and Sensory Polyneuropathy as the Presenting Symptom of SARS-CoV-2"],"prefix":"10.5811","volume":"4","author":[{"given":"Michael","family":"Kopscik","sequence":"first","affiliation":[{"name":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbra","family":"Giourgas","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina, Department of Neurology, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Presley","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Zhao H, Send D, Zhou H, et al. Guillain-Barr\u00e9 syndrome associated With SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. 2020;19(5):383-4.","DOI":"10.1016\/s1474-4422(20)30109-5"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Fisher CM. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N Engl J Med. 1956;255(2):57-65.","DOI":"10.1056\/nejm195607122550201"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Mori M, Kuwabara S, Fukutake T, et al. Clinical features and prognosis of Miller Fisher syndrome.\u00a0Neurology. 2001;56(8):1104-6.","DOI":"10.1212\/wnl.56.8.1104"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Mao L, Jin H, Wang M, et al. [Ahead of Print]. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China.\u00a0JAMA Neurol.\u00a0 April 10, 2020.","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Gutie\u0301rrez-Ortiz C, Me\u0301ndez A, Rodrigo-Rey S, et al. [Ahead of Print]. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology. April 17, 2020.","DOI":"10.1212\/WNL.0000000000009619"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Fern\u00e1ndez-Dom\u00ednguez J, Ameijide-Sanluis E, Garc\u00eda-Cabo C,\u00a0et al.\u00a0[Ahead of Print]. Miller\u2013Fisher-like syndrome related to SARS-CoV-2 infection (COVID 19).\u00a0J Neurol.\u00a0May 26, 2020.","DOI":"10.1007\/s00415-020-09912-2"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T19:06:48Z","timestamp":1600283208000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/35j1f5zf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,1]]},"references-count":6,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,8,6]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2020.6.48683","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2020,7,1]]}}}