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Bickerstaff's brainstem encephalitis: case report and Tc99m brain SPECT findings
P Nicolao1, M Zoccarato, M Dalsasso
1Service of Neurology, S. Maria del Prato Hospital, Feltre, Italy.
Summary
Bickerstaff
Area of Science:
- Neurology
- Immunology
Background:
- Bickerstaff's brainstem encephalitis (BBE) is a rare autoimmune disorder.
- It is characterized by a triad of ophthalmoplegia, ataxia, and altered consciousness.
Observation:
- A young female presented with severe neurological symptoms following an upper respiratory tract infection.
- Initial diagnostic tests, including MRI and SPECT, were inconclusive.
Findings:
- Diagnosis was confirmed by detecting high-titer serum anti-GQ1b IgG autoantibodies.
- Treatment with plasma exchange led to complete clinical recovery.
Implications:
- This case highlights the diagnostic utility of anti-GQ1b antibodies in BBE.
- Tc99m brain perfusion SPECT may have limited sensitivity for detecting brainstem lesions in BBE.
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