Miller fisher syndrome presents as an acute voice change to hypernasal speech


  • Delivered as a poster presentation at the Combined Otolaryngology Spring Meeting in Phoenix, Arizona, U.S.A., May 28–31, 2009.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.


The authors describe a 38-year-old man who presented with hypernasality, perioral and acroparesthesia, dyspnea, and dysphagia. Further evaluation revealed a diagnosis of Miller-Fisher syndrome (MFS). MFS is a variant of Guillain-Barré syndrome previously described in neurology and critical care journals; however, there is a paucity of work concerning this disease in the otolaryngology literature. An acute change in voice usually occurs secondary to inflammatory processes as seen after intubation and infection, but can occur as part of a more complex disease entity such as Guillain-Barré or Miller-Fisher syndrome. As such, clinicians should consider this in their evaluation of rhinolalia aperta. Laryngoscope, 2010