Bilateral Sixth Nerve Palsy and Nasal Voice in Two Sisters as a Variant of Guillan–Barré Syndrome

Francesco Pellegrini, Margaret Wang, Napoleone Romeo, Andrew G. Lee

Research output: Contribution to journalArticlepeer-review


A 6-year-old girl with acute pharyngitis presented with complaints of hypernasal speech and double vision. Examination revealed a bilateral abduction deficit associated with soft palate palsy causing rhinolalia aperta. Cerebrospinal fluid analysis showed albuminocytologic dissociation. Her sister also suffered from the same disorder, albeit milder, 1 month before. After treatment with intravenous immunoglobulin and steroids, the patient made a full recovery. After the case report, a brief discussion of Miller Fisher syndrome, Guillan–Barré syndrome, and their variants is made. This case highlights that bilateral sixth nerve palsy and rhinolalia aperta in the absence of ataxia should still raise suspicion for these autoimmune conditions that may rarely and atypically present in siblings.

Original languageEnglish (US)
Pages (from-to)1-3
Number of pages3
Issue number5
StateAccepted/In press - Jan 12 2018


  • Bilateral sixth nerve palsy
  • Guillan–Barré syndrome
  • Miller Fisher syndrome
  • polyneuritis cranialis
  • rhinolalia

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology


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