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Case No. 455
2017-09-01~2017-09-30
출제자 : 안성준
Hit : 277
| Period | 2017-09-01~2017-09-30 |
|---|---|
| Diagnosis | Bickerstaff brainstem encephalitis or anti-GQ1b antibody syndrome |
| Clinical information | 54/M C.C: vertigo and intermittent diplopia PHx : HTN/DM/Tb/Hep -/-/-/- |
| Discussion | • Mesencephalitis and rhombencephalitis in 1951 (Bickerstaff & Cloake) – external ophthalmoplegia, ataxia and altered consciousness, preceded by an infective episode, all of whom made good spontaneous recovery • Miller Fisher in 1956 – combination of external ophthalmoplegia, ataxia and areflexia, noting spontaneous recovery – IgG anti-GQ1b antibodies in 1992 – GQ1b antigen is highly expressed in the oculomotor, trochlear and abducens nerves, muscle spindles in the limbs, and probably reticular formation in the brainstem. – Infection by microorganisms bearing the GQ1b epitope may induce production of immunoglobulin G (IgG) anti-GQ1b antibodies in susceptible patients. |
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