Severe Bickerstaff's encephalitis treated with Rituximab: serum and CSF GQ1b antibodies

J Neuroimmunol. 2012 Oct 15;251(1-2):107-9. doi: 10.1016/j.jneuroim.2012.07.008. Epub 2012 Aug 4.


Bickerstaff's encephalitis is a syndrome of ophthalmoplegia, ataxia and impaired consciousness commonly associated with serum GQ1b antibodies. We describe a patient with seropositive Bickerstaff's encephalitis who did not respond either to plasma exchange or intravenous immunoglobulin but recovered following adjunct treatment with the anti-CD 20 monoclonal antibody, Rituximab. There was a concomitant reduction in serum GQ1b antibodies associated with improvement. Interestingly, GQ1b antibody was also detected in CSF. These findings have potentially significant clinical and immunopathological implications.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Autoantibodies / blood*
  • Autoantibodies / cerebrospinal fluid*
  • Encephalitis / diagnosis
  • Encephalitis / drug therapy*
  • Gangliosides / immunology*
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / cerebrospinal fluid
  • Immunologic Factors / therapeutic use*
  • Male
  • Rituximab
  • Severity of Illness Index
  • Treatment Outcome


  • Antibodies, Monoclonal, Murine-Derived
  • Autoantibodies
  • Gangliosides
  • Immunoglobulin G
  • Immunologic Factors
  • Rituximab
  • GQ1b ganglioside