Etiology matters for neuroprognostication: A multimodal electrophysiological investigation in a case of Bickerstaff's brainstem encephalitis.
Bickerstaff's brainstem encephalitis
Coma
Middle-latency auditory evoked potentials
Neuroprognostication
Somatosensory evoked potentials
Journal
Neurophysiologie clinique = Clinical neurophysiology
ISSN: 1769-7131
Titre abrégé: Neurophysiol Clin
Pays: France
ID NLM: 8804532
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
09
06
2022
revised:
19
09
2022
accepted:
19
09
2022
pubmed:
10
10
2022
medline:
28
10
2022
entrez:
9
10
2022
Statut:
ppublish
Résumé
We report the case of a 19-year-old patient with an acute-onset non-traumatic coma. Brain MRI scan was normal, CSF showed mild pleocytosis and moderately elevated protein, and continuous EEG-monitoring was compatible with spindle-coma. Cortical somatosensory evoked potentials (SSEPs) and middle-latency auditory evoked potentials (MLAEPs) were bilaterally absent, and brainstem auditory evoked potentials suggested a brainstem dysfunction. Serum anti-GQ1b and anti-GT1a IgG antibodies positivity suggested Bickerstaff's brainstem encephalitis (BBE). The clinical and functional outcomes were favorable and normal cortical SSEPs/MLAEPs reappeared in a few weeks. Based on this report, in cases of unexplained MRI-negative coma with neurophysiological evidence of brainstem dysfunction, BBE should be eliminated before considering withdrawal of life-sustaining therapy (WLST).
Identifiants
pubmed: 36210256
pii: S0987-7053(22)00086-7
doi: 10.1016/j.neucli.2022.09.004
pii:
doi:
Substances chimiques
Gangliosides
0
Immunoglobulin G
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
398-403Informations de copyright
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interests None.