title: Delayed facial weakness in Guillain-Barré and Miller Fisher syndromes.
abstract: BACKGROUND
  Dr. C. Miller Fisher described the appearance of unilateral facial palsy after resolution of ataxia in a patient with the eponymic Miller Fisher syndrome (MFS). However, there have been very few reports of delayed appearance of facial weakness in Guillain-Barré syndrome (GBS) and MFS when the other neurological signs reached nadir or started improving.
  
  
  METHODS
  In this study we reviewed the clinical and laboratory findings of consecutive patients with GBS (n=195) and MFS (n=68).
  
  
  RESULTS
  Delayed facial weakness occurred in 12 (6%) GBS and 4 (6%) MFS patients and was unilateral in 5 (42%) GBS and 2 (50%) MFS patients. In those patients with delayed facial weakness, neither limb weakness nor ataxia progressed, and facial weakness disappeared without immunotherapy.
  
  
  CONCLUSIONS
  Because facial weakness can lead to further morbidity, it would be prudent for clinicians to warn patients of this possibility, although additional immunotherapy is usually not required.
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Muneto
authors.initials: M
authors.lastname: Tatsumoto
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Sonoko
authors.initials: S
authors.lastname: Misawa
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kokubun
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Sekiguchi
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
authors.affiliation: Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Department of Medicine, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Unit 09-01, 14 Medical Drive, 117599, Singapore.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004568:Electrodiagnosis; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000150:complications* / Q000188:drug therapy; D018908:Muscle Weakness / Q000209:etiology*; D055815:Young Adult
chemical_list: D000906:Antibodies; D005732:Gangliosides; D016756:Immunoglobulins, Intravenous
keywords: Guillain-Barré syndrome; Miller Fisher syndrome; acute inflammatory demyelinating polyneuropathy; acute motor axonal neuropathy; facial palsy; facial weakness