{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:41:00Z","timestamp":1772113260827,"version":"3.50.1"},"reference-count":10,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,31]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Our patient was admitted to hospital with a 1-week history of an upper respiratory tract infection and a rapidly progressive encephalopathy dominated by brainstem features and widespread areflexia. Her antiganglioside antibodies and electroencephalography were consistent with Bickerstaff brainstem encephalitis (BBE), and her postmortem examination revealed a predominantly florid brainstem encephalitis and myelitis. Her sputum and throat swabs isolated <jats:italic>Haemophilus influenzae<\/jats:italic> and <jats:italic>Fusobacterium,<\/jats:italic> respectively, the former being the most probable trigger of BBE. Our patient\u2019s death, despite the otherwise good prognosis of the disorder, may reflect the severity of the pathological changes at postmortem or the association of comorbid disorders such as sepsis-associated encephalopathy. Her poor outcome may also be an indication to treat rapidly progressive cases of BBE with more than one immune modulating drug.<\/jats:p>","DOI":"10.1136\/bcr-2021-245588","type":"journal-article","created":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T10:25:15Z","timestamp":1643797515000},"page":"e245588","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Bickerstaff brainstem encephalitis: clinical, neurophysiological, laboratory and postmortem findings of a case presenting as encephalomyelitis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1857-6230","authenticated-orcid":false,"given":"Ibrahim","family":"Imam","sequence":"first","affiliation":[{"name":"Neurology, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ptolemaios G","family":"Sarrigiannis","sequence":"additional","affiliation":[{"name":"Neurophysiology, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya G","family":"Shivane","sequence":"additional","affiliation":[{"name":"Department of Cellular and Anatomical Pathology, University Hospitals Plymouth NHS Trust, Plymouth, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,2]]},"reference":[{"key":"2025082710571879000_15.2.e245588.1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg233"},{"key":"2025082710571879000_15.2.e245588.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-304993"},{"key":"2025082710571879000_15.2.e245588.3","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000889","article-title":"Bickerstaff brainstem encephalitis with or without anti-GQ1b antibody","volume":"7","author":"Yoshikawa","year":"2020","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"2025082710571879000_15.2.e245588.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-303060"},{"key":"2025082710571879000_15.2.e245588.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5032.1384"},{"key":"2025082710571879000_15.2.e245588.6","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/105.3.481"},{"key":"2025082710571879000_15.2.e245588.7","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s12028-012-9691-3","article-title":"Bickerstaff\u2019s Brainstem Encephalitis Presenting to the ICU","volume":"17","author":"Hunter","year":"2012","journal-title":"Neurocrit Care"},{"key":"2025082710571879000_15.2.e245588.8","doi-asserted-by":"crossref","first-page":"622","DOI":"10.12659\/PJR.898647","article-title":"Relapsing-Remitting Severe Bickerstaff\u2019s Brainstem Encephalitis \u2013 Case Report and Literature Review","volume":"81","author":"Tyrakowska","year":"2016","journal-title":"Pol J Radiol"},{"key":"2025082710571879000_15.2.e245588.9","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/NRL.0000000000000255","article-title":"A probable case of recurrent Bickerstaff brainstem encephalitis with fulminant course in a pediatric patient","volume":"25","author":"Chamsi Basha","year":"2020","journal-title":"Neurologist"},{"key":"2025082710571879000_15.2.e245588.10","doi-asserted-by":"crossref","first-page":"703","DOI":"10.3390\/jcm9030703","article-title":"Sepsis-Associated encephalopathy: from delirium to dementia?","volume":"9","author":"Chung","year":"2020","journal-title":"JCM"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-245588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:57:24Z","timestamp":1756317444000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-245588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,2]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/bcr-2021-245588"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-245588","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]}}}