Open AccessDiagnosis and prediction of prognosis for Bickerstaff’s brainstem encephalitis using auditory brainstem response: a case report
Author(s) -
Kurihara Toru,
Igarashi Yutaka,
Kobai Kaori,
Mizobuchi Taiki,
Ishii Hiromoto,
Matsumoto Noriko,
Yokobori Shoji,
Yokota Hiroyuki
Publication year - 2020
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.517
Subject(s) - brainstem , medicine , auditory brainstem response , cerebrospinal fluid , magnetic resonance imaging , encephalitis , audiology , brainstem auditory evoked potential , anesthesia , pathology , immunology , radiology , hearing loss , virus
Background It is difficult to diagnose Bickerstaff’s brainstem encephalitis (BBE) in the acute phase, and emergency physicians could diagnose BBE as an unknown cause of consciousness disturbance. Case presentation A 75‐year‐old woman presented with dizziness and weakness in both arms 1 week after an upper respiratory infection. She experienced gradual worsening of consciousness, had dilated pupils and no light reflex. She was suspected of brainstem dysfunction at the upper part of the brainstem; however, there were not significant findings on magnetic resonance imaging, cerebrospinal fluid, or electroencephalography. The auditory brainstem response demonstrated a low voltage, but there was no prolonged latency. At a later date, she was diagnosed with BBE based on serum immunoglobulin G anti‐GQ1b antibody. She was discharged home without any neurological sequelae. Conclusion It is necessary to analyze serum immunoglobulin G anti‐GQ1b antibodies to diagnose BBE. Auditory brainstem response would be helpful in detecting lesions and predicting functional recovery.