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Bickerstaff's brainstem encephalitis presenting to the ICU

Gary Hunter1, G Bryan Young, Lee Cyn Ang

  • 1Division of Neurology, Department of Medicine, University of Saskatchewan, 112 3502 Taylor St. E., Saskatoon, SK, S7V 1J1, Canada. grwhunter@gmail.com

Neurocritical Care
|May 25, 2012
PubMed
Abstract

Insights

Bickerstaff's brainstem encephalitis (BBE) is challenging to diagnose and treat, overlapping with other conditions. Early immunomodulation may improve outcomes for this rare neurological disorder.

Area of Science:

  • Neurology
  • Neuroimmunology

Background:

  • Bickerstaff's brainstem encephalitis (BBE) presents diagnostic and therapeutic challenges.
  • Clinical overlap exists with Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS).
  • Key features include impaired consciousness and long-tract signs.

Observation:

  • A case study of an elderly male with progressive weakness and altered consciousness.
  • Autopsy revealed inflammatory changes in nerve roots and brainstem.
  • Clinical course showed areflexia and loss of brainstem reflexes.

Findings:

  • BBE diagnosis remains primarily clinical, despite advanced testing.
  • Pathological findings consistent with literature on BBE.
  • The condition may represent a spectrum with GBS and MFS.

Implications:

  • BBE diagnosis requires careful clinical evaluation.
  • Early immunomodulatory therapy may shorten the disease course.
  • Further research into BBE's spectrum and treatment is warranted.

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