Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A pediatric case of Bickerstaff's brainstem encephalitis

  • Park, Ju Yi (Department of Pediatrics, Konyang University College of Medicine) ;
  • Ko, Kyong Og (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae Woo (Department of Pediatrics, Konyang University College of Medicine) ;
  • Cheon, Eun Jung (Department of Pediatrics, Konyang University College of Medicine) ;
  • Yoon, Jung Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Kim, Hyo Jeong (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2013.07.26
  • Accepted : 2013.10.10
  • Published : 2014.12.10
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Abstract

Bickerstaff's brainstem encephalitis is characterized by ophthalmoplegia, ataxia, and disturbance of consciousness. It is similar to Miller Fisher syndrome, a variant of Guillain-Barre syndrome, in that they share features such as ophthalmoplegia and ataxia. The difference is that patients with Bickerstaff's brainstem encephalitis have impaired consciousness, whereas patients with Miller Fisher syndrome have alert consciousness and areflexia. Here, we report the case of a 3-year-old child who was diagnosed with Bickerstaff's brainstem encephalitis presenting typical clinical features and interesting radiological findings. The patient showed ophthalmoplegia, ataxia, and subsequent stuporous mentality. Brain magnetic resonance imaging revealed high signal intensity in the pons and cerebellum around the 4th ventricle on a T2-weighted image. He was successfully treated with intravenous immunoglobulin. Differentiation of Bickerstaff's brainstem encephalitis and Miller Fisher syndrome is often difficult because they possess many overlapping features. Brain magnetic resonance imaging may be helpful in diagnosing Bickerstaff's brainstem encephalitis, especially when lesions are definitely found.

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References

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  1. Pediatric Bickerstaff brainstem encephalitis: a systematic review of literature and case series vol.265, pp.1, 2014, https://doi.org/10.1007/s00415-017-8684-8
  2. Bickerstaff Brainstem Encephalitis - A Serious Disease with a Favourable Outcome vol.16, pp.3, 2014, https://doi.org/10.7199/ped.oncall.2019.46