2014, Number 5
Med Int Mex 2014; 30 (5)
Lule-Alatorre KP, Domínguez-Borgua A, Martín-Ramírez JF, López-Galicia DN, Vázquez-Flores AD, Zaldívar-Clavellina AK
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ABSTRACTIn 1950 decade, Bickerstaff described a clinical setting preceded most cases by a febrile disease, that since its beginning shows evidence of participation of the brain stem, followed by a stationary period of 1-to-3 weeks and later spontaneous remission during several months, in which patient has somnolence as initial sign and data of central and peripheral nervous system compromise; he also described changes on cefaloraquid liquid and the electroencephalogram of these patients. Annual incidence of Bickerstaff encephalitis is calculated in 0.078 per 100,000 habitants, with a mild predominance of men (relation man:woman 1.3:1), with an average age of 39 years (median of 35 years). A great number of affected patients shows antibody anti-GQ1b; due to this seropositivity is observed in other diseases, such as Guillain-Barre and Miller-Fisher syndromes, many physicians believe that it forms part of the called anti-GQ1b syndromes. However, it has some different pathophysiological mechanisms that are responsible of the clinical and laboratory and imaging studies differences. Generally, it has been suggested the same treatment than that against other anti-GQ1b syndromes, but some ongoing studies propose a specific treatment against the pathophysiologic mechanism triggering Bickerstaff's encephalitis.