Diagnostic features and literature review of Bickerstaff brainstem encephalitis with positive antiGQ1b antibody
Zhao Mingjuan1, Wang Zhanhang2, Xu Yuzhen3, Ye Jinlong2, Kuang Zuying2, Li Dandan1
1Department of Neurology, Taian Municipal Hospital, Taian 271000, China; 2Department of Neurology, Guangdong Sanjiu Brain Hospital, Guangzhou 510000, China; 3Department of Neurology, Taian City Central Hospital, Taian 271000,China
Abstract：Objective To explore the diagnostic features of Bickerstaff brainstem encephalitis (BBE) with positive antiGQ1b antibody. MethodsThe clinical data of 3 BBE cases with positive anti-GQ1b antibody diagnosed by the Neurology Department of Guangdong Sanjiu Brain Hospital from February 2016 to May 2019 were retrospectively analyzed. Diagnostic features of BBE with positive anti-GQ1b antibody were summarized, and relevant literatures were reviewed. ResultsThe 3 patients were all female, with the age of 16, 19, 49 years old respectively, and all of them had a history of infection before the onset. All 3 cases had onset of ataxia, 2 cases had limb weakness at the onset, and 1 case developed consciousness disorder and limb weakness after aggravation. On physical examination, 3 patients had ophthalmoplegia, and 2 patients had positive pyramidal tract signs. Auxiliary examination: 3 patients presented positive of antiGQ1b antibodies, 3 patients showed no obvious abnormalities in brain magnetic resonance imaging (MRI) scan and enhancement, 2 patients had abnormal electromyogram evoked potentials, and 1 patient was normal. ConclusionsBBE is a syndrome that mainly manifests as acute ophthalmoplegia, ataxia accompanied by disturbance of consciousness and/or positive pyramidal tract signs. Thorough understanding of associated clinical features and serum antibody, imaging and nerve electrophysiological examination are helpful in achieving at the correct diagnosis.
