@article{Zayet2022, 
author = {Souheil Zayet and Hajer Zahra and Nabil Belfeki and Timothée Klopfenstein and Beate Hagenkötter},
title = {Atypical miller-fisher syndrome after COVID-19 and sleeve gastrectomy: Contribution of neurochemical markers to early diagnosis},
year = {2022},
journal = {Infectious Medicine},
volume = {1},
number = {2},
pages = {140-142},
keywords = {COVID-19, Miller-fisher syndrome, Wernicke encephalopathy, Bariatric surgery, Phosphorylated neurofilament heavy chain Protein},
url = {https://www.sciopen.com/article/10.1016/j.imj.2022.02.001},
doi = {10.1016/j.imj.2022.02.001},
abstract = {BackgroundThe coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. More recently, there have been sporadic case reports on development of Miller-Fisher Syndrome, a rare variant of Guillain-Barré Syndrome in COVID-19 patients.Case reportWe reported herein the case of a French young women presenting with ophtalmoplegia, cerebellar ataxia, and universal areflexia following a bariatric surgery (sleeve gastrectomy). A concomitant COVID-19 diagnosis was retained based on microbiological testing. The patient was successfully treated after high-dose intravenous thiamine, but areflexia persisted. Underlying COVID-19 related Miller-Fisher Syndrome was established on physical examination and confirmed by pathologic neurophysiological findings and elevated level of phosphorylated neurofilament heavy chain protein in cerebrospinal fluid analysis.ConclusionsGuillain-Barré Syndrome and its variants after SARS-CoV-2 infection are extremely rare. The measurement of phosphorylated neurofilament heavy chain protein should be considered as an easy tool to detect an early affection of the peripheral nervous system.}
}