Bickerstaff's brainstem encephalitis is a disorder within the spectrum of Guillain-Barre Syndrome. The brainstem shows a perivascular lymphocytic infiltration and there is peripheral motor axonal degeneration.
Most patients have a history of an infection with a virus or Camplyobacter jejuni preceding the clinical onset.
(3) disturbance of consciousness (drowsiness, stupor or coma)
Additional findings may include:
(1) hyperreflexia (brisk)
(2) facial diplegia
(3) Babinski's sign
(4) pupillary abnormality
(5) bulbar palsy
(6) flaccid tetraparesis
(7) hemisensory loss
(8) an abnormal brain MRI
(9) anti-ganglioside antibodies
The diagnosis requires exclusion of alternative diagnoses. The presence of drowsiness, Babinski's sign or hyperreflexia favors Bickerstaff's brainstem encephalitis over Miller Fisher Syndrome.
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