2014, Number 5
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Med Int Mex 2014; 30 (5)
Bickerstaff: Brainstem encephalitis
Lule-Alatorre KP, Domínguez-Borgua A, Martín-Ramírez JF, López-Galicia DN, Vázquez-Flores AD, Zaldívar-Clavellina AK
Language: Spanish
References: 26
Page: 575-583
PDF size: 449.56 Kb.
ABSTRACT
In 1950 decade, Bickerstaff described a clinical setting preceded most
cases by a febrile disease, that since its beginning shows evidence of
participation of the brain stem, followed by a stationary period of 1-to-3
weeks and later spontaneous remission during several months, in which
patient has somnolence as initial sign and data of central and peripheral
nervous system compromise; he also described changes on cefaloraquid
liquid and the electroencephalogram of these patients. Annual incidence
of Bickerstaff encephalitis is calculated in 0.078 per 100,000 habitants,
with a mild predominance of men (relation man:woman 1.3:1), with an
average age of 39 years (median of 35 years). A great number of affected
patients shows antibody anti-GQ1b; due to this seropositivity is observed
in other diseases, such as Guillain-Barre and Miller-Fisher syndromes,
many physicians believe that it forms part of the called anti-GQ1b syndromes.
However, it has some different pathophysiological mechanisms
that are responsible of the clinical and laboratory and imaging studies
differences. Generally, it has been suggested the same treatment than
that against other anti-GQ1b syndromes, but some ongoing studies propose a specific treatment against the pathophysiologic mechanism
triggering Bickerstaff's encephalitis.
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