title: Severe Bickerstaff's encephalitis treated with Rituximab: serum and CSF GQ1b antibodies.
abstract: Bickerstaff's encephalitis is a syndrome of ophthalmoplegia, ataxia and impaired consciousness commonly associated with serum GQ1b antibodies. We describe a patient with seropositive Bickerstaff's encephalitis who did not respond either to plasma exchange or intravenous immunoglobulin but recovered following adjunct treatment with the anti-CD 20 monoclonal antibody, Rituximab. There was a concomitant reduction in serum GQ1b antibodies associated with improvement. Interestingly, GQ1b antibody was also detected in CSF. These findings have potentially significant clinical and immunopathological implications.
authors.affiliation: Department of Neuroinflammation, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK. thardy@med.usyd.edu.au
authors.forename: Todd A
authors.initials: TA
authors.lastname: Hardy
authors.forename: Michael H
authors.initials: MH
authors.lastname: Barnett
authors.forename: Armin
authors.initials: A
authors.lastname: Mohamed
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Garsia
authors.forename: Leo
authors.initials: L
authors.lastname: Davies
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid*; D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy*; D005732:Gangliosides / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D000069283:Rituximab; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D005732:Gangliosides; D007074:Immunoglobulin G; D007155:Immunologic Factors; D000069283:Rituximab; C039129:GQ1b ganglioside