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Bickerstaff Brainstem Encephalitis

A rare post-infectious encephalitis with brainstem involvement.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Bickerstaff Brainstem Encephalitis?

Bickerstaff brainstem encephalitis is a rare autoimmune neurological disease that overlaps with Miller Fisher syndrome and presents with brainstem involvement. Its prominent feature is the addition of altered consciousness and pyramidal findings to the classical Miller Fisher triad.

It usually appears after an infection and the anti-GQ1b antibody may be positive in the blood. MR imaging may sometimes show lesions in the brainstem.

Although the disease may be severe, with appropriate treatment most patients recover completely or near-completely. Intensive care follow-up is important because of the possibility of respiratory involvement.

Symptoms

Confusion and drowsiness
Restricted eye movements, double vision
Imbalance and ataxia
Pyramidal findings (positive Babinski, increased reflexes)
Difficulty swallowing and speaking
Weakness
Rarely respiratory failure

Risk Factors

Previous respiratory or gastrointestinal infection
Campylobacter jejuni infection
Male sex
Young to middle age
Autoimmune predisposition
Vaccination (rare associated cases)
Previous Guillain-Barré spectrum history

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If altered consciousness and eye movement disorder appear after infection
  • If imbalance and weakness progress rapidly
  • If swallowing or breathing difficulty develops
  • If new symptoms requiring advanced neurological examination occur
  • New symptoms in patients previously diagnosed with Miller Fisher syndrome

Treatment Methods

01
Intensive care monitoring and respiratory support (when needed)
02
Intravenous immunoglobulin (IVIG)
03
Plasmapheresis
04
Corticosteroids (in selected cases)
05
Treatment of the underlying infection
06
Physiotherapy and rehabilitation
07
Long-term neurology follow-up
08
Multidisciplinary supportive care

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.