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Anti-GQ1b-Positive Bickerstaff Brainstem Encephalitis Complicated by Diffuse Hypertrophic Pachymeningitis: A Case
Taiki Matsubayashi1, Kaoru Morita1, Jun Terai1
1Department of Neurology, National Hospital Organization Disaster Medical Center, Japan.
Abstract:
A 36-year-old man developed acute progressive ataxia, an impaired consciousness, and ophthalmoplegia after an upper respiratory tract infection. A cerebrospinal fluid analysis revealed pleocytosis in the patient. Initial plain brain magnetic resonance imaging (MRI) showed no remarkable findings, whereas initial brain perfusion single-photon emission computed tomography demonstrated hyperperfusion in the brainstem. Follow-up contrast-enhanced MRI revealed diffuse dural thickening, and a histopathological examination supported the diagnosis of hypertrophic pachymeningitis. Anti-GQ1b antibodies were detected, leading to a diagnosis of Bickerstaff brainstem encephalitis (BBE). This case suggests that hypertrophic pachymeningitis may be a rare complication of BBE.
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