AI Article Synopsis
- The study aimed to clinically and immunologically evaluate cases of 'incomplete' Bickerstaff brainstem encephalitis (BBE) in two patients at a Singapore hospital.
- Both patients exhibited symptoms like excessive sleepiness and ataxia but lacked external eye movement issues, yet had high levels of specific antibodies associated with BBE.
- The findings suggest that absence of ophthalmoplegia should not rule out a diagnosis of BBE, leading to a potential classification of 'ataxic hypersomnolence without ophthalmoplegia'.
Article Abstract
Objective: Clinical and immunological evaluation of 'incomplete' Bickerstaff brainstem encephalitis (BBE).
Methods: We studied two patients with postinfectious brainstem syndromes who presented at National University Hospital Singapore. Laboratory work-up included measurement of antiganglioside antibodies.
Results: Both patients displayed hypersomnolence and cerebellar-like ataxia in the absence of external ophthalmoplegia and carried high serum titres of IgG anti-GQ1b antibodies, strongly indicative of BBE.
Conclusions: Ophthalmoplegia can be absent or incomplete in BBE, and the absence of this clinical feature should not exclude BBE from the clinicians' differential. Such cases of incomplete BBE could be defined as 'ataxic hypersomnolence without ophthalmoplegia'.
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| http://dx.doi.org/10.1136/jnnp-2013-304993 | DOI Listing |
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