Sharma Vijay, Chan Y C, Teoh H L, Wilder-Smith E P
Division of Neurology, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
J Clin Neurosci. 2006 Feb;13(2):277-9. doi: 10.1016/j.jocn.2005.01.011. Epub 2006 Jan 26.
Bickerstaff's brain-stem encephalitis is usually a monophasic post-viral inflammatory illness characterized by progressive ophthalmoplegia, ataxia and disturbance of consciousness (or hyper-reflexia). Since the clinical spectrum of Bickerstaff encephalitis may overlap with the Miller-Fisher and Guillain-Barré syndromes, the presence of anti- GQ1b antibodies and abnormal brain MRI can help to support its diagnosis. However, absence of anti-GQ1b antibodies and normal MRI do not exclude the diagnosis, which remains based on clinical criteria and exclusion of other etiologies. We report a case of recurrent Bickerstaff's brainstem encephalitis with no identifiable antecedent illness, and overlapping features of Miller Fisher and Guillain-Barré syndromes, in the presence of negative anti-GQ1b antibodies and repeatedly normal MRI of the brain.
比克斯特费尔德脑干脑炎通常是一种单相病毒性后炎症性疾病，其特征为进行性眼肌麻痹、共济失调和意识障碍（或反射亢进）。由于比克斯特费尔德脑炎的临床谱可能与米勒-费希尔综合征和格林-巴利综合征重叠，抗GQ1b抗体的存在及脑部MRI异常有助于支持其诊断。然而，抗GQ1b抗体阴性及MRI正常并不能排除诊断，诊断仍基于临床标准及排除其他病因。我们报告一例复发性比克斯特费尔德脑干脑炎病例，无前驱疾病，存在米勒-费希尔综合征和格林-巴利综合征的重叠特征，抗GQ1b抗体阴性且脑部MRI多次正常。
