Insights into antibody-associated encephalitis--Bickerstaff's 1950's papers revisited

J Neurol Sci. 2013 Nov 15;334(1-2):167-8. doi: 10.1016/j.jns.2013.07.010. Epub 2013 Aug 5.


Edwin Bickerstaff and Philip Cloake reported in the 1950's three cases of reversible encephalitis. The concept of antibody associated encephalitis had not been proposed at the time they astutely recognized the importance of disease pattern recognition and postulated a potential immune based mechanism. The syndrome defined by Bickerstaff of progressive, external ophthalmoplegia and ataxia, with disturbance of consciousness or hyperreflexia, has subsequently been associated with anti-GQ1b antibodies. Interestingly one of the three original cases, a young woman who developed seizures, an eye movement disorder and acute psychosis while awaiting ovarian cystectomy, has features that may be more consistent with anti-NMDA receptor encephalitis.

Keywords: Anti-NMDA receptor antibodies; Ataxia; Bickerstaff's brainstem encephalitis; Clinical history; Ophthalmoplegia; Psychosis.

Publication types

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

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / history
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / immunology
  • Antibodies, Anti-Idiotypic
  • Encephalitis / diagnosis
  • Encephalitis / history*
  • Encephalitis / immunology
  • Female
  • Gangliosides / immunology
  • History, 20th Century
  • Humans
  • Young Adult


  • Antibodies, Anti-Idiotypic
  • Gangliosides
  • GQ1b ganglioside