María R. Villacís-Vásquez, Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador Wilson F. Barahona-Ulloa, Department of Internal Medicine, Hospital “José Carrasco Arteaga.” Cuenca, Ecuador


Female patient presents respiratory infection 1 month before the appearance of following triad: ophthalmoplegia, ataxia, and hyporeflexia. Diagnosed as Miller Fisher syndrome, associated with cytomegalovirus infection, that showed an aggressive pattern in anti-GQ1b antibodies as well as albuminocytological dissociation in cerebrospinal fluid and demyelination in electromyography, without therapeutic response to intravenous immunoglobulin and plasmapheresis. The progression of the disorder leads to overlap with a classic Guillain–Barré syndrome, presented by the persistence of quadriparesis and dysphagia for solids/liquids, reflecting a poor prognosis, confirming that the etiologic agent has impact on the aggressiveness. This is also indicated in up-to-date literature, which justifies the importance of report.



Keywords: Autoimmune diseases of the nervous system. Polyradiculoneuropathy. Guillain–Barré syndrome. Miller Fisher syndrome. Cytomegalovirus.