Miller Fisher syndrome (MFS), characterized as ataxia, areflexia and 
ophthalmoplegia, is generally considered as a variant of Guillain-Barré syndrome 
(GBS). However, some investigators believed that the syndrome could be explained 
by a central origin. To obtain more information about MFS for comparison with 
GBS, we conducted a retrospective study by analyzing the clinical data of MFS 
patients admitted to our hospital over a period of 11 years. The calibrated 
male/female ratio was 1.65. A seasonal clustering in winter was noted. The 
percentage of MFS among GBS was especially high (18%, 11/60) in Taiwan when 
compared with other series. Involvement of limb muscle strength, autonomic 
function and cranial nerves, except ocular motor nerves, was rarely found in our 
patients. When MFS is accompanied by limb weakness, it might represent a 
transitional form between MFS and GBS. Bulbar palsy and dysautonomia might 
predict a relatively poor prognosis. To obtain more reliable information, lumbar 
puncture should be done 1 week after disease onset, and electrophysiological 
tests should be done serially in every MFS patient. Eighty percent (80%, 4/5) of 
our patients were positive for IgG anti-GQ(1b) antibody activity. In our study, 
there is more evidence indicating that MFS is a peripheral nervous system 
disorder; however, no definite conclusion could be made as to whether MFS is 
exclusively a peripheral or central nervous system disorder. We think MFS is an 
immune-mediated clinical entity which mainly involves the peripheral nervous 
system with rare involvement of other parts of the central nervous system.