A case of fisher-bickerstaff syndrome overlapped by guillain-barré syndrome

Daiki Fujii, Yasuhiro Manabe, Yosiaki Takahasi, Hisashi Narai, Nobuhiko Omori, Susumu Kusunoki, Koji Abe

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Abstract

We report a 72-year-old woman with overlapping Miller Fisher syndrome (MFS), Guillain-Barré syndrome (GBS) and Bickerstaff's brainstem encephalitis (BBE). She developed diplopia and unsteady gait a week after an upper respiratory infection on day 1. She had weakness of both upper limbs on day 3 and became drowsy, and her respiratory status worsened on day 5. Neurologic examination revealed ophthalmoplegia, ataxia, symmetrical weakness, areflexia, and consciousness disturbance. We diagnosed her with MFS on day 1, GBS on day 3 and overlapping BBE on day 5. She underwent immunoadsorption therapy and two courses of intravenous immunoglobulin therapy. Ten months after onset, her symptoms had fully recovered. Anti-GM1 IgG, GD1a IgG, GQ1b IgG, and GT1a IgG antibodies were positive. Our case supports the notion that MFS, GBS, and BBE are all part of a continuous clinical spectrum, which is an antibody-mediated process.

Original languageEnglish
Pages (from-to)212-215
Number of pages4
JournalCase Reports in Neurology
Volume4
Issue number3
DOIs
Publication statusPublished - Sep 1 2012

Keywords

  • Bickerstaff's brainstem encephalitis
  • Guillain-Barré syndrome
  • Miller Fisher syndrome

ASJC Scopus subject areas

  • Clinical Neurology

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    Fujii, D., Manabe, Y., Takahasi, Y., Narai, H., Omori, N., Kusunoki, S., & Abe, K. (2012). A case of fisher-bickerstaff syndrome overlapped by guillain-barré syndrome. Case Reports in Neurology, 4(3), 212-215. https://doi.org/10.1159/000345847