Bickerstaff’s brainstem encephalitis, Miller Fisher syndrome and Guillain-Barré syndrome overlap in an asthma patient with negative anti-ganglioside antibodies

Authors

Chongyu Han, You Anmen HospitalFollow
Yuan Wang, Xuan Wu Hospital of Capital Medical University, People's Republic of ChinaFollow
Jianping Jia, Xuan Wu Hospital of Capital Medical University, People's Republic of ChinaFollow
Xunming Ji, Xuan Wu Hospital of Capital Medical University, People's Republic of ChinaFollow
Vance Fredrickson, Wayne State University School of MedicineFollow
Yuchuan Ding, Wayne State University School of MedicineFollow
Wei Sun, Xuan Wu Hospital of Capital Medical University, People's Republic of ChinaFollow
Jia Xu, You Anmen Hospital, People's Republic of ChinaFollow
Yong-Xin Sun, Xuan Wu Hospital of Capital Medical University, People's Republic of ChinaFollow

Document Type

Article

Abstract

Abstract

Background

Bickerstaff’s brainstem encephalitis (BBE), together with Miller Fisher syndrome (MFS) and Guillain-Barré syndrome (GBS) were considered to form a continuous clinical spectrum. An anti-GQ1b antibody syndrome has been proposed to underlie the common pathophysiology for the three disorders; however, other studies have found a positive anti-GM1 instead of anti-GQ1b antibody.

Case presentation

Here we report a 20-year-old male patient with overlapping BBE, MFS and GBS. The patient had a positive family history of bronchial asthma and had suffered from the condition for over 15 years. He developed BBE symptoms nine days after an asthma exacerbation. During the course of illness, he had significantly elevated IgE levels in both serum and cerebrospinal fluid. Serologic analysis of antibodies against ganglioside complexes (anti-GDIa, anti-GDIb, anti-GM1, anti-GM2, anti-GM3, anti-GQIb and anti-GTIb antibodies) showed negative results.

Conclusions

Since asthma has recently been related to autoimmune disease, our case supports an autoimmune mechanism underlying the clinical spectrum composed of BBE, MFS and GBS. However, contrary to a proposed anti-GQ1b antibody syndrome, we would suggest that pathogenesis of this clinical spectrum is not limited to anti-ganglioside antibodies.

Disciplines

Neurology | Surgery

Recommended Citation

Han et al.: Bickerstaff’s brainstem encephalitis, Miller Fisher syndrome and Guillain-Barré syndrome overlap in an asthma patient with negative anti-ganglioside antibodies. BMC Research Notes 2012 5:295.