Overlapping Guillain-Barré Syndrome and Bickerstaff's Brainstem Encephalitis Associated With anti-GQ1b IgG Antibody After Herpes Simplex Virus Infection

Acta Neurol Scand. 2001 Jul;104(1):57-60. doi: 10.1034/j.1600-0404.2001.00288.x.


Herpes simplex virus (HSV) is a rare, antecedent infectious agent in Guillain-Barré syndrome (GBS). We report a patient with overlapping GBS and Bickerstaff's brainstem encephalitis (BBE). The patient had a vesicular lesion on her nose. Antecedent HSV type 1 (HSV-1) infection was confirmed by isolation of the virus and detection of the presence of serum anti-HSV-1 IgM antibody during the acute phase. Her serum IgG had high anti-GQ1b antibody titer. External ophthalmoplegia has been noted in 2 of 4 reported cases of HSV-associated GBS. Herpetic brainstem encephalitis cases of poor prognosis are known, but only 2 cases of benign brainstem encephalitis secondary to HSV infection, in which there was acute ophthalmoplegia and clinical features consistent with those of BBE have been reported.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies / analysis
  • Autoantibodies / immunology
  • Brain Stem / pathology*
  • Brain Stem / virology
  • Encephalitis, Viral / etiology*
  • Encephalitis, Viral / virology
  • Female
  • Guillain-Barre Syndrome / etiology*
  • Guillain-Barre Syndrome / virology
  • Herpes Simplex / complications*
  • Herpesvirus 1, Human / immunology
  • Herpesvirus 1, Human / isolation & purification
  • Humans
  • Immunoglobulin G / analysis
  • Immunoglobulin G / immunology
  • Middle Aged
  • Ophthalmoplegia / drug therapy


  • Autoantibodies
  • Immunoglobulin G