Bilateral ballism in a patient with overlapping Fisher's and Guillain-Barre syndromes

A 29 year old woman developed diplopia and ataxic gait. Neurological examination showed total ophthalmoplegia, cerebellar ataxia, and areflexia. Moreover, there was muscle weakness in all four limbs. An overlap of Fisher’s and Guillain-Barré syndromes was dignosed. On day 5 she suddenly developed involuntary flinging movements that affected the face and four limbs. Surface EMG showed 1.5–2 Hz rhythmic grouping discharges. The involuntary...