Bickerstaff's brainstem encephalitis associated with anti-GM1 and anti-GD1a antibodies.


Journal

BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291

Informations de publication

Date de publication:
18 Sep 2020
Historique:
entrez: 19 9 2020
pubmed: 20 9 2020
medline: 20 2 2021
Statut: epublish

Résumé

Bickerstaff's brainstem encephalitis (BBE) is a Guillain-Barré syndrome (GBS) spectrum disorder associated with predominantly central nervous system predilection. Patients exhibit a variable constellation of depressed consciousness, bilateral external ophthalmoplegia, ataxia and long tract signs. Although the pathophysiology is not fully understood, it has been associated with anti-GQ1b antibodies in two-thirds of patients. We present a patient with clinical features consistent with BBE and positive anti-GM1 and anti-GD1a antibodies. A diagnostic approach to the acutely unwell patient with brainstem encephalitis is explored in this clinical context with a literature review of the aforementioned ganglioside antibody significance. Intravenous immunoglobulin therapy is highlighted in BBE using up-to-date evidence-based extrapolation from GBS.

Identifiants

pubmed: 32948528
pii: 13/9/e236545
doi: 10.1136/bcr-2020-236545
pmc: PMC7511636
pii:
doi:

Substances chimiques

Autoantibodies 0
Gangliosides 0
ganglioside, GD1a 12707-58-3
G(M1) Ganglioside 37758-47-7

Types de publication

Journal Article Case Reports

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Jonathan Cleaver (J)

Department of Neurology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK jonathan.cleaver@nhs.net.

Richard James (R)

Department of Neuroradiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.

Gurjit Chohan (G)

Department of Neurology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.

Paul Lyons (P)

Department of Neurology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.

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Classifications MeSH