Bickerstaff's brainstem encephalitis mimicking herpetic encephalomyelitis in a liver transplant patient with anti-GQ1b antibodies.
BMJ Case Rep
; 15(12)2022 Dec 13.
Article
in English
| MEDLINE | ID: covidwho-2161824
ABSTRACT
A woman in her late 70s with a history of liver transplant presented with ophthalmoplegia, ataxia, areflexia, positive Babinski's sign and reduced consciousness. This followed an antecedent illness in the form of a herpes zoster infection. MRI of the brain/spinal cord, cerebrospinal fluid analysis with viral PCR and routine blood tests were normal, and tacrolimus neurotoxicity was ruled out. Serum anti-GQ1b antibodies were positive. A diagnosis of Bickerstaff's brainstem encephalitis was made, forming part of the continuum that involves Miller-Fisher syndrome, entitled the 'anti-GQ1b syndrome'. Complete recovery ensued without intravenous immunoglobulins or plasma exchange. The role of monitoring anti-ganglioside pattern change to predict or confirm disease recurrence and disease severity is further discussed.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Skin Diseases, Infectious
/
Liver Transplantation
/
Miller Fisher Syndrome
/
Encephalitis
/
Encephalomyelitis
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
/
Variants
Limits:
Female
/
Humans
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Bcr-2022-251784
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