Hi Christian: This is very difficult to answer as your nerves have been given a clean bill of health by the neurologist whom you saw and it seems that he has been very thorough. Long-lasting residual fatigue is common after the usual forms of GBS but uncommon after Miller Fisher unless there was some limb weakness as well. It is important to make sure that your doctors have checked for other potential causes of fatigue like low thyroid function, anemia or a sleep disorder. The other fluctuating symptoms are sufficiently nonspecific that I have difficulty coming up with an explanation. I am generally very supportive of getting a 2nd opinion in obscure cases like yours but I am not optimistic that there is going to be a satisfacgtory anwer for you. I will forward your questions to Suzie Mudge who has just compelted a study on fatigue after GBS and she will have some good advice on how to manage that symptom. Sorry to be of so little help. On a related note, it would be great if you were willing to participate in our ongoing research study. If you are will to do that you should contact Dr Eileen McManus at emcm373@aucklanduni.ac.nz

Gareth