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Bickerstaff's brainstem encephalitis associated with IgM antibodies to GM1b and GalNAc-GD1a.
J Neurol Sci. 2004 Feb 15; 217(2):225-8.JN

Abstract

This is the first report of a case of Bickerstaff's brainstem encephalitis (BBE) associated with IgM antibodies to GM1b and GalNAc-GD1a. Subsequent to Campylobacter jejuni enteritis, the patient rapidly developed consciousness disturbance and hyperreflexia in addition to external ophthalmoplegia and cerebellar-like ataxia. EEG showed transient 7 Hz monorhythmic theta activities, predominantly in the front-central area. He received high doses of immunoglobulin intravenously and had completely recovered 3 months later. High anti-GM1b and anti-GalNAc-GD1a IgM antibody titers present during the acute phase decreased with his clinical improvement. An absorption study showed the anti-GM1b and anti-GalNAc-GD1a IgM antibodies to be cross-reactive. Anti-GM1b and anti-GalNAc-GD1a antibodies have been detected in some patients who developed Guillain-Barré syndrome after C. jejuni enteritis, whereas the anti-GQ1b IgG antibody is associated with BBE. Infection by C. jejuni bearing a GM1b-like or GalNAc-GD1a-like lipooligosaccharide may trigger the production of anti-GalNAc-GD1a and anti-GM1b IgM antibodies. It is not clear why our patient developed BBE rather than Guillain-Barré syndrome. These antibodies may, however, prove useful serological markers for identifying BBE patients who do not have the anti-GQ1b IgG antibody.

Authors+Show Affiliations

Department of Pediatrics, Saga Medical School, Saga, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

14706228

Citation

Matsuo, Muneaki, et al. "Bickerstaff's Brainstem Encephalitis Associated With IgM Antibodies to GM1b and GalNAc-GD1a." Journal of the Neurological Sciences, vol. 217, no. 2, 2004, pp. 225-8.
Matsuo M, Odaka M, Koga M, et al. Bickerstaff's brainstem encephalitis associated with IgM antibodies to GM1b and GalNAc-GD1a. J Neurol Sci. 2004;217(2):225-8.
Matsuo, M., Odaka, M., Koga, M., Tsuchiya, K., Hamasaki, Y., & Yuki, N. (2004). Bickerstaff's brainstem encephalitis associated with IgM antibodies to GM1b and GalNAc-GD1a. Journal of the Neurological Sciences, 217(2), 225-8.
Matsuo M, et al. Bickerstaff's Brainstem Encephalitis Associated With IgM Antibodies to GM1b and GalNAc-GD1a. J Neurol Sci. 2004 Feb 15;217(2):225-8. PubMed PMID: 14706228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bickerstaff's brainstem encephalitis associated with IgM antibodies to GM1b and GalNAc-GD1a. AU - Matsuo,Muneaki, AU - Odaka,Masaaki, AU - Koga,Michiaki, AU - Tsuchiya,Katsunori, AU - Hamasaki,Yuhei, AU - Yuki,Nobuhiro, PY - 2004/1/7/pubmed PY - 2004/4/29/medline PY - 2004/1/7/entrez SP - 225 EP - 8 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 217 IS - 2 N2 - This is the first report of a case of Bickerstaff's brainstem encephalitis (BBE) associated with IgM antibodies to GM1b and GalNAc-GD1a. Subsequent to Campylobacter jejuni enteritis, the patient rapidly developed consciousness disturbance and hyperreflexia in addition to external ophthalmoplegia and cerebellar-like ataxia. EEG showed transient 7 Hz monorhythmic theta activities, predominantly in the front-central area. He received high doses of immunoglobulin intravenously and had completely recovered 3 months later. High anti-GM1b and anti-GalNAc-GD1a IgM antibody titers present during the acute phase decreased with his clinical improvement. An absorption study showed the anti-GM1b and anti-GalNAc-GD1a IgM antibodies to be cross-reactive. Anti-GM1b and anti-GalNAc-GD1a antibodies have been detected in some patients who developed Guillain-Barré syndrome after C. jejuni enteritis, whereas the anti-GQ1b IgG antibody is associated with BBE. Infection by C. jejuni bearing a GM1b-like or GalNAc-GD1a-like lipooligosaccharide may trigger the production of anti-GalNAc-GD1a and anti-GM1b IgM antibodies. It is not clear why our patient developed BBE rather than Guillain-Barré syndrome. These antibodies may, however, prove useful serological markers for identifying BBE patients who do not have the anti-GQ1b IgG antibody. SN - 0022-510X UR - https://www.unboundmedicine.com/medline/citation/14706228/Bickerstaff's_brainstem_encephalitis_associated_with_IgM_antibodies_to_GM1b_and_GalNAc_GD1a_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022510X03002855 DB - PRIME DP - Unbound Medicine ER -