Treatment of Bickerstaff's brainstem encephalitis with immune globulin.
Bickerstaff's brainstem encephalitis (BBE) is an immune disorder of unknown etiology. Previous reports of successful treatment of BBE involved steroids or plasma exchange. We describe a patient with BBE who demonstrated rapid clinical recovery after treatment with intravenous immune globulin. Our findings suggest that IVIg is an alternative treatment in BBE, especially when plasma exchange is difficult or contraindicated. Our patient also demonstrated pseudoretraction and pseudoptosis during clinical recovery, an observation which supports a differential immune attack on components of the third nerve or supranuclear regions, and expands our understanding of the pathophysiology of BBE.
Fox
R J
RJ
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Kasner
S E
SE
Galetta
S L
SL
Chalela
J A
JA
D000328:Adult; D001933:Brain Stem; D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous