Miller Fisher syndrome is a rare, acquired nerve disease that is considered to be a variant of Guillain-Barré syndrome. It is characterized by abnormal muscle coordination, paralysis of the eye muscles, and absence of the tendon reflexes. Like Guillain-Barré syndrome, symptoms may be preceded by a viral illness. Additional symptoms include generalized muscle weakness and respiratory failure. The majority of individuals with Miller Fisher syndrome have a unique IgG anti-GQ1b 1bantibody that characterizes the disorder. In this report we describe a unusual presentation of Miller Fisher syndrome, having wasting of small muscles of both hands and plantars extensors.