title: Recurrent Guillain-Barré syndrome, Miller Fisher syndrome and Bickerstaff brainstem encephalitis.
abstract: OBJECTIVE
  Guillain-Barré syndrome (GBS), Miller Fisher syndrome (MFS), and Bickerstaff brainstem encephalitis (BBE) are usually monophasic, but some patients experience recurrences after long asymptomatic intervals. We aimed to investigate clinical features of recurrent GBS, MFS, and BBE at a single hospital.
  
  
  METHODS
  Records from 97 consecutive patients with GBS, MFS or BBE who were admitted to a tertiary hospital between 2001 and 2013 were reviewed. Clinical and laboratory features of patients with recurrent GBS, MFS, or BBE were investigated.
  
  
  RESULTS
  Patients included 55 (32 males) with GBS, 34 (22 males) with MFS, and 8 (6 males) with BBE. Recurrent cases occurred in 2 (4%) of the 55 patients with GBS, 4 (12%) of the 34 patients with MFS, and 2 (25%) of the 8 patients with BBE. Patients with recurrent MFS had a tendency to be younger at the first episode than patients with non-recurrent MFS (median, 22 versus 37years old). Symptoms and signs were less severe during relapses than during the initial episode in recurrent patients.
  
  
  CONCLUSIONS
  Recurrences occurred more frequently in patients with MFS or BBE compared with those with GBS. Patients with recurrent MFS might be younger than those with non-recurrent MFS.
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Japan. Electronic address: ishii-j@kcho.jp.
authors.forename: Junko
authors.initials: J
authors.lastname: Ishii
authors.affiliation: Brain and Mind Centre, University of Sydney, Australia. Electronic address: gbs.yuki.cidp@gmail.com.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Japan. Electronic address: kawamoto@kcho.jp.
authors.forename: Michi
authors.initials: M
authors.lastname: Kawamoto
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Japan. Electronic address: hajime-y@kcho.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yoshimura
authors.affiliation: Department of Neurology, Kinki University School of Medicine, Japan. Electronic address: kusunoki-tky@umin.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Japan. Electronic address: kohara-kcgh@umin.ac.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kohara
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood; D015703:Antigens, CD / Q000276:immunology; D001933:Brain Stem / Q000473:pathology*; D054221:Classical Lissencephalies and Subcortical Band Heterotopias / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D004660:Encephalitis / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000906:Antibodies; D015703:Antigens, CD; D005732:Gangliosides
keywords: Bickerstaff brainstem encephalitis; Guillain-Barré syndrome; Miller Fisher syndrome; Recurrence