# Navigating Diagnostic Dilemmas: Miller Fisher Syndrome in Pregnancy Masquerading As Stroke

## TL;DR

This case report discusses a rare neurological condition during pregnancy that mimics a stroke, emphasizing the importance of accurate diagnosis and timely treatment.

## Contribution

The novelty lies in highlighting diagnostic challenges of Miller Fisher Syndrome during pregnancy and its potential misdiagnosis as stroke.

## Key findings

- MFS can present with symptoms similar to posterior circulation stroke, leading to diagnostic confusion.
- Early recognition and treatment of MFS are crucial for better clinical outcomes in affected patients.
- Pregnancy can complicate the clinical presentation and management of MFS.

## Abstract

Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS) characterized by a clinical triad of acute ophthalmoplegia, ataxia, and areflexia. Despite being a rare, acquired demyelinating nerve disease, a higher incidence has been reported among the Asian population, where the incidence is estimated to be 18-26% of GBS compared to 3-5% among the Western population. An acute presentation of MFS can mimic a posterior circulation stroke. Other differential diagnosis includes Wernicke’s encephalopathy (WE), which is characterized by a clinical triad of ophthalmoplegia, nystagmus, and ataxia. In this case report, we describe a pregnant lady who presented with an acute onset of binocular diplopia, dizziness, nausea, and vomiting. This case highlights the importance of early recognition of MFS features, the diagnostic challenges associated with it, and the significance of prompt treatment in improving clinical outcomes.