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

Bickerstaff's Brainstem Encephalitis: Can It Recur?

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Case Reports

Bickerstaff's Brainstem Encephalitis: Can It Recur?

Vijay Sharma et al. J Clin Neurosci. .

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.

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