Bickerstaff's Brainstem Encephalitis Suspected as Functional Neurologic Disorders.

Area of Science:

• Neurology
• Immunology

Background:

• Functional neurologic disorders present with unexplained neurological symptoms.
• Differentiating these from organic neurological conditions can be challenging.

Observation:

• A 21-year-old woman initially diagnosed with functional neurologic disorder presented with limb numbness and weakness.
• Cerebrospinal fluid showed monocytes, and EEG revealed widespread slow waves.

Findings:

• Encephalitis was suspected, leading to steroid pulse therapy with symptom improvement.
• Subsequent testing revealed anti-GQ1b IgG antibodies, confirming Bickerstaff's brainstem encephalitis (BBE).

Implications:

• This case highlights the diagnostic difficulty between functional neurologic disorders and BBE.
• Awareness of BBE is crucial for physicians and psychiatrists to ensure appropriate patient management.