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Updated: Apr 23, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Delayed facial weakness in Guillain-Barré and Miller Fisher syndromes
Muneto Tatsumoto1, Sonoko Misawa2, Norito Kokubun1
1Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
Introduction:
Dr. C. Miller Fisher described the appearance of unilateral facial palsy after resolution of ataxia in a patient with the eponymic Miller Fisher syndrome (MFS). However, there have been very few reports of delayed appearance of facial weakness in Guillain-Barré syndrome (GBS) and MFS when the other neurological signs reached nadir or started improving.
Methods:
In this study we reviewed the clinical and laboratory findings of consecutive patients with GBS (n=195) and MFS (n=68).
Results:
Delayed facial weakness occurred in 12 (6%) GBS and 4 (6%) MFS patients and was unilateral in 5 (42%) GBS and 2 (50%) MFS patients. In those patients with delayed facial weakness, neither limb weakness nor ataxia progressed, and facial weakness disappeared without immunotherapy.
Conclusions:
Because facial weakness can lead to further morbidity, it would be prudent for clinicians to warn patients of this possibility, although additional immunotherapy is usually not required.
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