Bickerstaff's brainstem encephalitis: can it recur?

J Clin Neurosci. 2006 Feb;13(2):277-9. doi: 10.1016/j.jocn.2005.01.011. Epub 2006 Jan 26.

Abstract

Bickerstaff's brain-stem encephalitis is usually a monophasic post-viral inflammatory illness characterized by progressive ophthalmoplegia, ataxia and disturbance of consciousness (or hyper-reflexia). Since the clinical spectrum of Bickerstaff encephalitis may overlap with the Miller-Fisher and Guillain-Barré syndromes, the presence of anti- GQ1b antibodies and abnormal brain MRI can help to support its diagnosis. However, absence of anti-GQ1b antibodies and normal MRI do not exclude the diagnosis, which remains based on clinical criteria and exclusion of other etiologies. We report a case of recurrent Bickerstaff's brainstem encephalitis with no identifiable antecedent illness, and overlapping features of Miller Fisher and Guillain-Barré syndromes, in the presence of negative anti-GQ1b antibodies and repeatedly normal MRI of the brain.

Publication types

  • Case Reports

MeSH terms

  • Brain Stem*
  • Consciousness
  • Electroencephalography
  • Encephalitis / physiopathology*
  • Gangliosides / analysis
  • Gangliosides / immunology
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Miller Fisher Syndrome / complications
  • Neurologic Examination
  • Ophthalmoplegia / etiology
  • Paralysis / etiology
  • Physical Therapy Modalities
  • Recurrence

Substances

  • Gangliosides
  • GQ1b ganglioside