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[Bickerstaff's brainstem encephalitis associated with cytomegalovirus infection]
Rinsho Shinkeigaku = Clinical Neurology
|April 1, 1994
Summary
A rare case of Bickerstaff's brainstem encephalitis, a neurological disorder, was linked to Cytomegalovirus (CMV) infection in a teenage girl. This finding highlights a potential new cause for this serious condition.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Bickerstaff's brainstem encephalitis (BBE) is a rare neurological disorder.
- Cytomegalovirus (CMV) is a common virus with varied clinical manifestations.
Observation:
- A 17-year-old female presented with acute onset of drowsiness, diplopia, gait difficulty, fever, headache, and fatigue.
- Neurological examination revealed ophthalmoplegia, ataxia, and hyporeflexia.
- Cerebrospinal fluid (CSF) analysis showed increased cells and anti-CMV antibody titers, with CMV-DNA detected by PCR.
- Serum anti-GQ1b antibody was positive.
Findings:
- The patient's symptoms resolved completely with normalization of CSF parameters and negative CMV-DNA PCR.
- This case represents the first reported instance of Bickerstaff's brainstem encephalitis associated with CMV infection.
- Transient forced laughing was observed during recovery.
Implications:
- Cytomegalovirus infection should be considered in the differential diagnosis of Bickerstaff's brainstem encephalitis.
- This association expands the known spectrum of neurological complications associated with CMV.
- Further research is warranted to understand the pathogenic mechanisms linking CMV to BBE.