BACKGROUND Miller Fisher syndrome is a variant of acute inflammatory demyelinating polyneuropathy classically characterized by ataxia, ophthalmoplegia, and areflexia. Miller Fisher syndrome can present with uncommon symptoms such as bulbar, facial, and somatic muscle palsies and micturition disturbance. CASE PRESENTATION We describe the case of a 76-year-old white man with new-onset ataxia, stridor, areflexia, and upper and lower extremity weakness who required intubation at presentation. An initial work-up including imaging studies and serum tests was inconclusive. Eventually, neurophysiological testing and cerebrospinal fluid analysis suggested a diagnosis of Miller Fisher syndrome. Our patient responded to treatment with intravenous immunoglobulin and supportive therapy. CONCLUSION The occurrence of acute or subacute descending paralysis with involvement of bulbar muscles and respiratory failure can often divert clinicians to a diagnosis of neuromuscular junction disorders (such as botulism or myasthenia gravis), vascular causes like stroke, or electrolyte and metabolic abnormalities. Early identification of Miller Fisher syndrome with appropriate testing is essential to prompt treatment and prevention of further, potentially fatal, deterioration.

中文翻译：

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Miller Fisher综合征伴双侧声带麻痹：一例报告。

背景技术Miller Fisher综合征是急性炎症性脱髓鞘性多发性神经病的一种变体，其典型特征为共济失调，眼肌麻痹和反射障碍。Miller Fisher综合征可表现出罕见的症状，例如延髓，面部和躯体肌肉麻痹和排尿障碍。病例介绍我们描述了一个76岁的白人，患有新发性共济失调，喘鸣，反射力减弱以及上肢和下肢无力，需要在演示时进行插管。初步的检查包括影像学检查和血清检查尚无定论。最终，神经生理学检查和脑脊液分析提示诊断为Miller Fisher综合征。我们的患者对静脉内免疫球蛋白和支持疗法的治疗有反应。结论伴有延髓肌和呼吸衰竭的急性或亚急性下降性麻痹的发生通常可将临床医生转移到诊断神经肌肉连接障碍（例如肉毒中毒或重症肌无力），中风等血管病或电解质和代谢异常方面。对米勒·费雪综合症进行早期识别并进行适当的检测对于及时治疗和预防进一步的，可能致命的恶化至关重要。