title: Overlapping Guillain-Barré syndrome and Bickerstaff's brainstem encephalitis associated with anti-GQ1b IgG antibody after herpes simplex virus infection.
abstract: Herpes simplex virus (HSV) is a rare, antecedent infectious agent in Guillain-Barré syndrome (GBS). We report a patient with overlapping GBS and Bickerstaff's brainstem encephalitis (BBE). The patient had a vesicular lesion on her nose. Antecedent HSV type 1 (HSV-1) infection was confirmed by isolation of the virus and detection of the presence of serum anti-HSV-1 IgM antibody during the acute phase. Her serum IgG had high anti-GQ1b antibody titer. External ophthalmoplegia has been noted in 2 of 4 reported cases of HSV-associated GBS. Herpetic brainstem encephalitis cases of poor prognosis are known, but only 2 cases of benign brainstem encephalitis secondary to HSV infection, in which there was acute ophthalmoplegia and clinical features consistent with those of BBE have been reported.
authors.affiliation: Department of Neurology, Dokkyo University School of Medicine, Japan. yuki@dokkyomed.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Yuki
authors.forename: K
authors.initials: K
authors.lastname: Susuki
authors.forename: M
authors.initials: M
authors.lastname: Odaka
authors.forename: K
authors.initials: K
authors.lastname: Hirata
mesh_terms: D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D001933:Brain Stem / Q000473:pathology* / Q000821:virology; D018792:Encephalitis, Viral / Q000209:etiology* / Q000821:virology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000209:etiology* / Q000821:virology; D006561:Herpes Simplex / Q000150:complications*; D018259:Herpesvirus 1, Human / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000276:immunology; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000188:drug therapy
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G