{"pk":858,"title":"A Case Report of Acute Motor and Sensory Polyneuropathy as the Presenting Symptom of SARS-CoV-2","subtitle":null,"abstract":"Introduction:\n Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically presents with respiratory illness and fever, however some rare neurologic symptoms have been described as presenting complaints. We report a case of an acute motor and sensory polyneuropathy consistent with Miller-Fisher Syndrome (MFS) variant of Guillain Barre Syndrome (GBS) as the initial symptom.\nCase Report:\n A 31-year old Spanish speaking male presents with two months of progressive weakness, numbness, and difficult walking. He had multiple cranial nerve abnormalities, dysmetria, ataxia, and absent lower extremity reflexes. An extensive workup including infectious, autoimmune, paraneoplastic, metabolic and neurologic testing was performed. Initially SARS-CoV-2 was not suspected based on a lack of respiratory symptoms. However, workup revealed a positive SARS-CoV-2 polymerase chain reaction test as well as presence of Anti-Ganglioside – GQ1b (Anti-GQ1b) immunoglobulin G antibodies.\nDiscussion:\n Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome (GBS) characterized by a triad of ophthalmoplegia, ataxia, and areflexia. The patient’s exam and workup including Anti-GQ1b is consistent with MFS.\nConclusion:\n SARS-CoV-2 infection in patients can have atypical presentations similar to this neurologic presentation. Prompt recognition and diagnosis can minimize the risk of transmission to hospital staff and facilitate initiation of treatment.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"SARS-CoV-2"},{"word":"COVID"},{"word":"COVID-19"},{"word":"Miller Fisher syndrome"},{"word":"Guillain-Barré syndrome"},{"word":"motor and sensory polyneuropathy"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/35j1f5zf","frozenauthors":[{"first_name":"Michael","middle_name":"R.","last_name":"Kopscik","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"},{"first_name":"Barbra","middle_name":"K.","last_name":"Giourgas","name_suffix":"","institution":"Medical University of South Carolina, Department of Neurology, Charleston, South Carolina","department":"None"},{"first_name":"Bradley","middle_name":"C.","last_name":"Presley","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"}],"date_submitted":"2020-07-01T23:46:05Z","date_accepted":"2020-07-01T23:46:05Z","date_published":"2020-07-01T23:47:19Z","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/858/galley/608/download/"}]}