Miller Fisher syndrome initially presented as bilateral internuclear ophthalmoplegia: a case report

Miller Fisher syndrome can present with various forms of ophthalmoplegia. This case report describes a 57-year-old woman who initially showed bilateral internuclear ophthalmoplegia (INO), with normal imaging and laboratory findings. Her neurologic symptoms progressed to include hyporeflexia and ataxia, leading to a diagnosis of Miller Fisher syndrome. Intravenous immunoglobulin treatment resulted in gradual improvement. This case report highlights the need to consider rare conditions like Miller Fisher syndrome in patients with INO-like features and unclear etiology.