A 41-year-old man presents 10 days after acute gastroenteritis with diplopia, gait unsteadiness, and mild proximal leg weakness. Vital signs: BP 138/82, HR 92, RR 18, temp 37.2°C, SpO2 98%. Neurologic exam reveals absent deep tendon reflexes bilaterally and mild ophthalmoplegia. CSF analysis shows elevated protein (78 mg/dL) with normal glucose and cell count. He denies recent vaccination. Which of the following is the most likely diagnosis?
- A)Multiple sclerosis
- B)Miller Fisher variant of Guillain Barré syndromeGABARITO
- C)Myasthenia gravis
- D)Botulism
- E)Lambert Eaton myasthenic syndrome
Explicação
The triad of ophthalmoplegia, ataxia, and areflexia is classic for the Miller Fisher variant of Guillain Barré syndrome. This variant is often associated with anti GQ1b antibodies and may follow the same postinfectious immune trigger as typical GBS. Ver explicação completa e trilha adaptativa →