COVID-19-Associated Miller Fisher Syndrome With Long Latency Period: A Case Report

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Coronavirus disease 2019 (COVID-19) is increasingly recognized for its multi-systemic effects beyond respiratory complications.
• Neurological complications post-COVID-19 infection are a growing area of concern.
• Miller Fisher syndrome (MFS), a rare variant of Guillain-Barré syndrome (GBS), has been documented following COVID-19.

Observation:

• A 26-year-old male developed COVID-19-associated MFS with a 10-week latency period post-infection.
• This represents the youngest adult case reported and the second youngest overall, following a pediatric case.
• The patient presented with dysphagia, horizontal diplopia, facial weakness, limb weakness, and paresthesia.

Findings:

• Treatment with intravenous immunoglobulin led to rapid symptom resolution within four days for most symptoms.
• A significant recovery was observed, with only residual left-sided facial weakness at one-year follow-up.
• This case highlights the potential for prolonged latency and varied presentations of MFS post-COVID-19.

Implications:

• The findings suggest increased variability in GBS and MFS presentations due to COVID-19's multi-systemic impact.
• Further research into long-term follow-ups of COVID-19 patients is crucial for understanding post-viral complications.
• This case expands the known spectrum of neurological sequelae associated with SARS-CoV-2 infection.