Mill operator Fisher disorder (SMF) is a monophasic polyradiculopathy. It is portrayed by the great ternion of ophthalmoplegia(กล้ามเนื้อตาอ่อนแรง which is the term in Thai Ophthalmoplegia)  ataxia, and areflexia. It is normally connected with respiratory or stomach related diseases.

We present the instance of a patient with SMF whose lone foundation was to have been immunized against this season’s cold virus five days prior.

Clinical case

A 64-year-old male persistent was alluded to the Ophthalmology crisis division for double vision and unsteadiness, without evidently other striking indications; be that as it may, insecurity in standing was not legitimate just by diplopia.

As the main history of intrigue, the patient announced having been immunized against this season’s flu virus five days prior.

The visual sharpness was 0.7 in the two eyes (AO), and exhibited both widened and refractive understudies, with no past contact with mydriatics It displayed a restriction in the kidnapping of OA, more prominent in the left eye (OI) in the supraduction of OA  and trouble for the remainder of the visual developments, alluding to flat diplopia. The rest of the eye assessment was ordinary.

At the point when the conclusion is associated with a Miller Fisher disorder, he is alluded to the Neurology Department, which identifies an ataxic walk, hyporeflexia, and precludes appendage shortcoming, choosing confirmation for development and complete investigation. The aftereffects of blood tests and registered tomography (CT) performed in the crisis division were typical.

At 24 hours after affirmation, respiratory trouble gave the idea that necessary oxygen and physiotherapy, and in the next weeks, he grew new neurological manifestations: facial loss of motion, dysphonia, and dysphagia.

During affirmation, a lumbar cut was performed in which an egg whites cytological separation was distinguished, and an atomic attractive reverberation imaging (MRI) that unquestionably precluded space-involving sore or demyelination. The electromyographic study didn’t give extra data.

The immunological examination was specific for the counter GQ-1b immunizer, unquestionably affirming the underlying analysis.

The patient improved from his side effects two weeks after confirmation, having gotten two cycles of immunoglobulins. The clinical advancement was moderate and polysymptomatic, with diplopia enduring with restricted reciprocal snatching.


Mill operator Fisher disorder is a fringe neurological condition that is related as a rule with an irresistible procedure (1), particularly respiratory or stomach related. The normal time of the beginning of neurological side effects after contamination is 1-2 weeks, and the analysis depends on exhibiting seroconversion. It is once in a while connected with the procedure in its intense stage (2). Our case was not related to persistent or intense disease, yet with this season’s cold virus immunization.