Abstract
Certain neurological conditions may closely resemble acute stroke in their clinical presentation, complicating the diagnostic process and potentially delaying appropriate treatment. This report presents a clinical case that illustrates the diagnostic difficulties encountered at the onset of Miller Fisher syndrome(MFS), a rare variant of Guillain-Barré syndrome(GBS). A 42-year old male patient initially exhibited symptoms commonly associated with ischemic stroke in the posterior circulation, including unilateral ptosis, double vision, dizziness, difficulty swallowing, reduced voice strength, ataxia, and limb weakness. Despite these signs, diffusion-weighted magnetic resonance imaging(DWI-MRI)revealed no evidence of acute cerebral ischemia. The development of ophthalmoplegia and absence of reflexes raised suspicion of an alternative neurological disorder. Subsequent serological testing confirmed the presence of anti-GQ1b antibodies, and treatment with intravenous immunoglobulins was initiated, resulting in significant clinical improvement. This case highlights the importance of maintaining a broad differential diagnosis in patients with atypical neurological symptoms and emphasizes the role of comprehensive evaluation in avoiding misdiagnosis. Awareness of such presentations can aid in earlier recognition of Miller Fisher syndrome and improve outcomes for individuals with rare autoimmune neuropathies.Keywords:strokemimics,Guillain-Barresyndrome,MillerFishersyndrome,GQ1b antibodies.