Anti-GQ1b Negative Miller Fisher Syndrome Mimicking Acute Sphenoid Sinusitis

Miller Fisher Syndrome is a variant of Guillain-Barre Syndrome, classically characterized by the triad of ataxia, areflexia and ophthalmoplegia. However, many conditions can mask the presentation of Miller Fisher Syndrome, potentially leading to grave consequences due to delayed diagnosis or even misdiagnosis.

We describe a case of Miller Fisher Syndrome mimicking acute sphenoid sinusitis with intracranial complications in an otherwise healthy 19-year-old man. Accurate diagnosis with prompt treatment led to full clinical recovery of our patient.

Sphenoid sinusitis warrants great vigilance and thorough neurological examination due to its proximity to structures such as the cavernous sinus and its associated cranial nerves. This case highlights its potential to mask more devastating conditions like Miller Fisher Syndrome and the successful role of medical management without the need for sphenoidotomy.