Bickerstaff brainstem encephalitis: clinical, neurophysiological, laboratory and postmortem findings of a case presenting as encephalomyelitis

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Authors
Imam, I.
Sarrigiannis, P. G.
Shivane, A. G.
Journal
BMJ case reports
Type
Case Reports
Publisher
BMJ
Rights
© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Our patient was admitted to hospital with a 1-week history of an upper respiratory tract infection and a rapidly progressive encephalopathy dominated by brainstem features and widespread areflexia. Her antiganglioside antibodies and electroencephalography were consistent with Bickerstaff brainstem encephalitis (BBE), and her postmortem examination revealed a predominantly florid brainstem encephalitis and myelitis. Her sputum and throat swabs isolated Haemophilus influenzae and Fusobacterium, respectively, the former being the most probable trigger of BBE. Our patient's death, despite the otherwise good prognosis of the disorder, may reflect the severity of the pathological changes at postmortem or the association of comorbid disorders such as sepsis-associated encephalopathy. Her poor outcome may also be an indication to treat rapidly progressive cases of BBE with more than one immune modulating drug.
Citation
BMJ Case Rep. 2022 Feb 2;15(2):e245588. doi: 10.1136/bcr-2021-245588.
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