title: Bickerstaff's brainstem encephalitis complicating Salmonella Paratyphi A infection.
abstract: Patients with enteric fever frequently develop neurological complications during their illness. Among them, majority has encephalopathy, but focal deficits or peripheral nervous involvements are occasionally encountered. We describe a young woman who developed a neurological syndrome consistent with Bickerstaff's brainstem encephalitis, with symptoms and signs including convulsion, impaired consciousness, external ophthalmoplegia, ataxia, bulbar palsy and pyramidal signs, following Salmonella Paratyphi A infection. This is the first case report of this syndrome after S. Paratyphi A infection, and it is the second case of Bickerstaff's brainstem encephalitis complicating enteric fever reported in the literature. This case also demonstrated, for the first time, a positive anti-GQ1b IgG response in a patient with Bickerstaff's brainstem encephalitis and related disorders that appear as complications during enteric fever.
authors.affiliation: Department of Medicine & Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong. shengbun@hotmail.com
authors.forename: Bun
authors.initials: B
authors.lastname: Sheng
authors.forename: Wing Sze
authors.initials: WS
authors.lastname: Ho
authors.forename: Kwok Kwong
authors.initials: KK
authors.lastname: Lau
authors.forename: Dilys Choi Yu
authors.initials: DC
authors.lastname: Lui
authors.forename: Bosco Hoi Shiu
authors.initials: BH
authors.lastname: Lam
authors.forename: Eric Yuk Tat
authors.initials: EY
authors.lastname: Chan
mesh_terms: D000328:Adult; D001259:Ataxia / Q000209:etiology; D001921:Brain / Q000473:pathology; D001933:Brain Stem / Q000473:pathology*; D003244:Consciousness Disorders / Q000209:etiology; D004660:Encephalitis / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009886:Ophthalmoplegia / Q000209:etiology; D010243:Paralysis / Q000209:etiology; D010284:Paratyphoid Fever / Q000150:complications* / Q000473:pathology; D012482:Salmonella paratyphi A; D013226:Status Epilepticus / Q000209:etiology; D014717:Vertigo / Q000209:etiology