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1、DOI:10.1093/brain/awg233AdvancedAccesspublicationJuly7,2003Brain(2003),126,2279±2290Bickerstaff'sbrainstemencephalitis:clinicalfeaturesof62casesandasubgroupassociatedwithGuillain±BarreÂsyndromeMasaakiOdaka,1NobuhiroYuki,1MitsunoriYamada,2MichiakiKoga,1ToshihikoTakem
2、i,3KoichiHirata1andSatoshiKuwabara41DepartmentofNeurology,DokkyoUniversitySchoolofCorrespondenceto:NobuhiroYuki,MD,PhD,DepartmentMedicine,Tochigi2DepartmentofPathology,BrainofNeurology,DokkyoUniversitySchoolofMedicine,ResearchInstitute,NiigataUniversity,Niigata3Depa
3、rtmentKitakobayashi880,Mibu,Shimotsuga,Tochigi321-0293,ofNeurology,StLuke'sInternationalHospital,TokyoandJapan4DepartmentofNeurology,ChibaUniversitySchoolofE-mail:yuki@dokkyomed.ac.jpDownloadedfromMedicine,Chiba,JapanSummaryBickerstaffreportedeightpatientswho,inaddi
4、tiontocourseandgenerallyagoodoutcome.Serumanti-GQ1bacuteophthalmoplegiaandataxia,showeddrowsiness,IgGantibodywaspositivein66%,andMRIshowedbrain.oxfordjournals.orgextensorplantarresponsesorhemisensoryloss.Thisbrainabnormalityin30%ofthepatients.Anotherconditionhasbeen
5、namedBickerstaff'sbrainstemence-strikingfeaturewastheassociationwith¯accidsym-phalitis(BBE).Onepatienthadgross¯accidweaknessmetricaltetraparesis,seenin60%ofthepatients.Aninthefourlimbs.PresumablybecauseoftherarityofautopsystudyofaBBEpatientclearlyshowedthepres-thisd
6、isorder,therehasbeennoreportedstudyonaenceofde®nitein¯ammatorychangesinthebrainstem:largenumberofpatientswithBBE.Toclarifyitsclin-therewasperivascularlymphocyticin®ltrationwithicalfeatures,werevieweddetailedclinicalpro®lesandoedemaandglialnodules.Electrodiagnosticst
7、udybyguestonMarch8,2011laboratory®ndingsfor62casesofBBEdiagnosedbyresultssuggestedperiphealmotoraxonaldegeneration.thestrictcriteriaofprogressive,relativelysymmetricalLimbweaknessintheBBEcasesstudiedwascon-externalophthalmoplegiaandataxiaby4weeks,andsideredtheresult
8、ofoverlapwiththeaxonalsubtypeofdisturbanceofconsciousnessorhyperre¯exia.Ninety-Guillain±BarreÂsyndrome.These®ndingscon®rmthattwopercentoft
