Two separate cranial nerve variants of Guillain-Barre syndrome(GBS) have been reported. One is Miller-Fisher syndrome,the other is polyneuritis cranialis. Involvement of the extraocular muscles in variants of GBS is well recognized,but complete external and internal opthalmoplegia is rare. Optic neuritis remains the only consistent, albeit very uncommon,evidence of inflammation of central nervous system myelin in GBS. This propose that GBS is part of a spectrumof central and peripheral inflammation.This case is an unusual clinical variant who had ptosis, opthalmoplegia, areflexia, ataxia, optic neurritis, markedoropharyngeal, and neck and shoulder weakness. This combined regional from is able to misdiagnose initially as botulismor diphtheria and less so, myasthenia. So if we were consider variant from of GBS, it is possible for make a correctdiagnosis more easily and treatment without delay.
