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A pediatric case of Bickerstaff's brainstem encephalitis
Ju Yi Park1, Kyong Og Ko1, Jae Woo Lim1
1Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
Korean Journal of Pediatrics
|February 6, 2015
Summary
Bickerstaff's brainstem encephalitis, a rare neurological condition, presents with eye movement issues, poor coordination, and altered consciousness. MRI findings can aid in its diagnosis, distinguishing it from similar syndromes.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimmunology
Background:
- Bickerstaff's brainstem encephalitis (BBE) shares symptoms like ophthalmoplegia and ataxia with Miller Fisher syndrome (MFS), a Guillain-Barré syndrome variant.
- Key distinctions include impaired consciousness in BBE versus alert consciousness and areflexia in MFS.
Purpose of the Study:
- To report a pediatric case of Bickerstaff's brainstem encephalitis.
- To highlight typical clinical and radiological findings in a child with BBE.
- To discuss diagnostic challenges and imaging utility in differentiating BBE from MFS.
Main Methods:
- Case report of a 3-year-old child diagnosed with BBE.
- Clinical assessment including ophthalmoplegia, ataxia, and altered consciousness.
- Brain magnetic resonance imaging (MRI) with T2-weighted sequences.
- Treatment with intravenous immunoglobulin (IVIG).
Main Results:
- The patient presented with classic BBE symptoms: ophthalmoplegia, ataxia, and stuporous mentality.
- Brain MRI revealed characteristic high signal intensity in the pons and cerebellum near the 4th ventricle.
- Successful treatment outcome was achieved with IVIG.
Conclusions:
- Differentiating BBE and MFS can be challenging due to overlapping clinical features.
- Brain MRI, particularly T2-weighted imaging showing specific lesions, is a valuable tool for diagnosing BBE.
- Early diagnosis and treatment, such as with IVIG, are crucial for favorable outcomes in pediatric BBE.
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