{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:59:52Z","timestamp":1756382392014,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,6]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Bickerstaff\u2019s brainstem encephalitis (BBE) is a Guillain-Barr\u00e9 syndrome (GBS) spectrum disorder associated with predominantly central nervous system predilection. Patients exhibit a variable constellation of depressed consciousness, bilateral external ophthalmoplegia, ataxia and long tract signs. Although the pathophysiology is not fully understood, it has been associated with anti-GQ1b antibodies in two-thirds of patients. We present a patient with clinical features consistent with BBE and positive anti-GM1 and anti-GD1a antibodies. A diagnostic approach to the acutely unwell patient with brainstem encephalitis is explored in this clinical context with a literature review of the aforementioned ganglioside antibody significance. Intravenous immunoglobulin therapy is highlighted in BBE using up-to-date evidence-based extrapolation from GBS.<\/jats:p>","DOI":"10.1136\/bcr-2020-236545","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T13:50:15Z","timestamp":1600437015000},"page":"e236545","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Bickerstaff\u2019s brainstem encephalitis associated with anti-GM1 and anti-GD1a antibodies"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9657-5815","authenticated-orcid":false,"given":"Jonathan","family":"Cleaver","sequence":"first","affiliation":[{"name":"Department of Neurology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"James","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Royal United Hospitals Bath NHS 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