Introduction:

The SARS-CoV-2 pandemic has caused an avalanche of information about the affectation of different systems including the central and peripheral nervous systems.

Objective:

Report the first case in the locality with acute respiratory syndrome due to SARS-CoV-2 that acutely presented Miller Fisher syndrome and facial diplegia.

Clinical case:

46-year-old female who initially presented anosmia, ageusia, right ophthalmoparesis, passing to bilateral ophthalmoplegia, mild ataxia, areflexia, facial diplegia, moderate dysphagia, albumine-cytological dissociation in CSF and positive test for GD1b-IgG antibodies. Five days earlier, she had developed a cough, malaise, headache, and fatigue. The oropharyngeal smear test for (COVID-19) by the qualitative real-time reverse transcriptase polymerase chain reaction assay was positive, being negative in CSF.

Managed with intravenous immunoglobulin and acetaminophen. Two weeks after discharge, she was referred to rehabilitation for the physical management of facial diplegia.

Conclusions:

The first case of Miller Fisher syndrome and cranial polyneuritis during the COVID-19 pandemic is reported in Leon, Guanajuato, Mexico. Neurological manifestations can occur due to an aberrant immune response to COVID-19.