Koyama S, Kuroda K, Aizawa H, Kikuchi K, Kusunoki S
Department of Internal Medicine, National Hospital Nayoro.
Rinsho Shinkeigaku. 1998 Sep;38(9):849-52.
We presented a case of Bickerstaff's brainstem encephalitis. A 50-year-old woman developed semicoma, external ophthalmoplegia, hyporeflexia, extensor plantar responses. A high titer of anti-GQ1b IgG antibody was detected in her acute phase serum. Auditory brainstem response suggested the presence of brainstem lesion. Although MRI and CSF showed no abnormality, one-and-a-half syndrome was observed during the clinical course, suggesting involvement of the pontine tegmentum. She received steroid pulse-therapy and symptoms disappeared completely. Our case suggested that anti-GQ1b IgG antibody might relate to the pathogenesis of intramedullary as well as extramedullary lesions.
我们报告了一例Bickerstaff脑干脑炎病例。一名50岁女性出现半昏迷、外展神经麻痹、反射减退、巴宾斯基征阳性。在其急性期血清中检测到高滴度的抗GQ1b IgG抗体。听觉脑干反应提示存在脑干病变。尽管MRI和脑脊液检查未见异常,但在临床过程中观察到了一个半综合征,提示脑桥被盖受累。她接受了类固醇冲击治疗,症状完全消失。我们的病例提示抗GQ1b IgG抗体可能与髓内及髓外病变的发病机制有关。