Bickerstaff’s brainstem encephalitis: case report and Tc99m brain SPECT findings

Nicolao, P.; Zoccarato, Marco; Dalsasso, M.; Zucchetta, Pietro; Padoan, Roberto; Michielan, F.; Tavolato, B.

doi:10.1007/s10072-011-0598-0

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…SPECT could be abnormal in BE while MRI is normal. Indeed, in a recent case report of BE with normal MRI, SPECT showed hypoperfusion of the whole cerebral hemispheres and basal ganglia with relative sparing of the thalami and of the brainstem [28]. SPECT might therefore be a diagnostic tool in BE despite a lack of specificity.…”

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confidence: 99%

Chronic Bickerstaff’s encephalitis with cognitive impairment, a reality?

et al. 2014

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BackgroundBickerstaff’s encephalitis (BE) is an acute post-infectious demyelinating disease with albuminocytological dissociation. A chronic form has rarely been described previously.Case presentationA 44-year-old man was hospitalized for drowsiness, cognitive complaint limb weakness, ataxia and sensory disturbance after diarrhea. Neuropsychological evaluation showed slowing, memory and executive function impairment, while analysis of the CSF showed albuminocytological dissociation. Immunologic tests showed positive anti-ganglioside antibodies (anti-GM1 IgM, anti-GD1a IgG and anti-GD1b IgM). Brain MRI was normal but SPECT showed bilateral temporal and frontal hypoperfusion. Outcome under immunoglobulin treatment (IVIG) was favorable with an initial improvement but was marked by worsening after a few weeks. Consequently, the patient was treated with IVIG every 2 months due to the recurrence of symptoms after 6 weeks.ConclusionThis case raises the question of the existence of a chronic form of BE with cognitive impairment, in the same way as chronic inflammatory demyelinating polyneuropathy is considered to be a chronic form of Guillain–Barré syndrome.

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Section: Discussionmentioning

confidence: 99%

Chronic Bickerstaff’s encephalitis with cognitive impairment, a reality?

et al. 2014

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“…Neurologists should be aware that diffuse brain hypometabolism or vasogenic edema can be associated with BBE. 1,2…”

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Teaching Neuro Images : Extensive vasogenic edema in Bickerstaff brainstem encephalitis

et al. 2023

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Ten days after respiratory infection, a 32-year-old woman presented with headaches, ataxia, and diplopia without encephalopathy. Brain MRI revealed extensive white matter, brainstem, and cerebellar vasogenic edema, without gadolinium enhancement, partially regressive during follow-up (figure, A). CSF revealed transient elevated protein level (1.01 g/L) and hypercellularity (123 neutrophils/mm3). Negative anti-GQ1b but positive anti-GD1a immunoglobulin G led to the diagnosis of Bickerstaff brainstem encephalitis (BBE). Symptoms resolved within 10 days without treatment. 18FDG-PET showed bilateral temporo-parieto-occipital and cerebellar hypometabolism (figure, B). Neurologists should be aware that diffuse brain hypometabolism or vasogenic edema can be associated with BBE.1,2

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“…Neurologists should be aware that diffuse brain hypometabolism or vasogenic edema can be associated with BBE. 1,2 AUTHOR CONTRIBUTIONS E. Nerrant, C. Fourcade, S. Coulette, C. Lechiche, and E. Thouvenot participated in drafting/revising the manuscript.…”

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confidence: 99%