Very low. My attending said it was only the second time he'd seen it in his life... But after the first, it's something he would always keep in his pocket as a differential. Assuming the patient fit the profile, of course.
And I don't even remember learning about Miller-Fisher syndrome. I need to brush up on weird ass illnesses as my recert is coming in a year or two.
Can't say I heard about it before I saw it either. All I knew was that it looked like Guillain-Barre except weird. The neurologist was the one who said it was Miller-Fisher. Then again, I never got a chance to follow up on it so I don't know if it was actually Miller-Fisher in the end or not. It was a weird time anyway, we had half a dozen Gullain-Barre patients present all at once, so who knows. Filled up half the neuro ward. We even got a call from the Swedish CDC asking what the hell was going on. It got chalked up to a statistical anomaly in the end.
My first patient as a fresh medical student starting a neuro rotation had Miller-Fisher and the next had CJD. My consultant told me it would most likely be the last one I encountered throughout my medical career. Weird how these super rare things tend to crop up as a student.
Haha, yeah. Everyone I shadowed as a student kept complaining to me that it was their worst days ever and that I was attracting weird shit. Once I became a doctor myself it stopped - except when I have students, then it's back to being House MD again. I swear, students are bad luck or something.