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Raymond P. Roos, MD; Betty Soliven, MD; Fernando Goldenberg, MD; Aamir Badruddin, MD; Joseph M. Baron, MD

Arch Neurol. 2008;65(6):821-824.

Background  Bickerstaff brainstem encephalitis (BBE) is a rare inflammatory, demyelinating disease that generally has a good prognosis.

Objective  To describe the course of a patient with severe BBE and multiple medical complications.

Design  Case report.

Setting  Academic medical center.

Patient  An 81-year-old woman with BBE who fully recovered. The patient had transient and very frequent episodes of brainstem dysfunction during the recovery phase.

Main Outcome Measures  Clinical and biochemical evaluation with magnetic resonance imaging.

Conclusions  Bickerstaff brainstem encephalitis is a potentially reversible syndrome that needs early diagnosis (facilitated by magnetic resonance imaging) and prompt aggressive and supportive treatment. Frequent episodes of transient brainstem dysfunction occurred in our patient during recovery, possibly due to ephaptic transmission.

Author Affiliations: Departments of Neurology (Drs Roos, Soliven, Goldenberg, and Badruddin) and Medicine (Dr Baron), University of Chicago Medical Center, Chicago, Illinois.