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The author reports his experience with his own case of Miller-Fisher syndrome (MFS) and discusses the spectrum of GQ 1b-positive oculomotor nerve diseases, including MFS, Bickerstaff's brainstem encephalitis, Guillain-Barré syndrome, ophthalmoplegia without ataxia and isolated oculomotor palsies.

Neurological complications are among the most common in Mycoplasma pneumoniae (M.p.) infection and appear in up to 4,8 % of M.p.-infected patients . Whereas direct intracerebral infection can occur and often puts patients into critical, intensive care-requiring conditions, different forms of parainfectious autoimmune Guillain-Barré-syndrome (GBS) and Miller-Fisher syndrome (MFS) make up the most frequent neurological complications. M.p.-associated alterations of the blood count are common, and sometimes can take a dramatical course. We here report a 64-year-old female and a 53-year-old male patient who both suffered from severe parainfectious autoimmune neurological syndromes in combination with different forms of anemia, in the case of the first patient to a transfusion-requiring degree. With this report we would like to stress the importance to include M.p. in the diagnostic procedures in the case of inflammatory neurological syndromes, especially when combined with alterations of the blood count.

We report a 52-year-old patient with Miller Fisher syndrome and discuss Wernicke's encephalopathy as one important differential diagnosis. This article focuses on diagnostic criteria and possible nosological relations between Miller Fisher syndrome, Guillain-Barré syndrome with ophthalmoplegia, Bickerstaff's brainstem encephalitis, and acute ophthalmoparesis without ataxia.

A 47 year old male patient with Miller-Fisher-syndrome did not respond to treatment with plasmapheresis and intravenous high dose 7 S immune globulins. Only cerebrospinal fluid pheresis, administered as final alternative, lead to definite improvement and cure.