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MRI of the brain\/spinal cord, cerebrospinal fluid analysis with viral PCR and routine blood tests were normal, and tacrolimus neurotoxicity was ruled out. Serum anti-GQ1b antibodies were positive. A diagnosis of Bickerstaff\u2019s brainstem encephalitis was made, forming part of the continuum that involves Miller-Fisher syndrome, entitled the \u2018anti-GQ1b syndrome\u2019. Complete recovery ensued without intravenous immunoglobulins or plasma exchange. The role of monitoring anti-ganglioside pattern change to predict or confirm disease recurrence and disease severity is further discussed.<\/jats:p>","DOI":"10.1136\/bcr-2022-251784","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T10:59:20Z","timestamp":1670929160000},"page":"e251784","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Bickerstaff\u2019s brainstem encephalitis mimicking herpetic encephalomyelitis in a liver transplant patient with anti-GQ1b antibodies"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7004-4568","authenticated-orcid":false,"given":"Sehajdev Singh","family":"Bhatia","sequence":"first","affiliation":[{"name":"Emergency Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Canepa","sequence":"additional","affiliation":[{"name":"Stroke and Neurology, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9409-8130","authenticated-orcid":false,"given":"Asha","family":"Notarianni","sequence":"additional","affiliation":[{"name":"General Surgery, Jersey General Hospital, Saint Helier, Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"2025082710274240000_15.12.e251784.1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-303060"},{"key":"2025082710274240000_15.12.e251784.2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg233"},{"key":"2025082710274240000_15.12.e251784.3","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410310619"},{"key":"2025082710274240000_15.12.e251784.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-302824"},{"key":"2025082710274240000_15.12.e251784.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-0277(00)00127-X"},{"key":"2025082710274240000_15.12.e251784.6","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000497"},{"key":"2025082710274240000_15.12.e251784.7","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0b013e3283465715"},{"key":"2025082710274240000_15.12.e251784.8","doi-asserted-by":"publisher","DOI":"10.1309\/N82CTQ1J0XEVEFQB"},{"key":"2025082710274240000_15.12.e251784.9","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480180015001"},{"key":"2025082710274240000_15.12.e251784.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2010.00547.x"},{"key":"2025082710274240000_15.12.e251784.11","doi-asserted-by":"crossref","DOI":"10.1111\/tid.13038","article-title":"Varicella zoster virus encephalitis in solid organ transplant recipients: case series and review of literature","volume":"21","author":"Kang","year":"2019","journal-title":"Transpl Infect Dis"},{"key":"2025082710274240000_15.12.e251784.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003023420906"},{"key":"2025082710274240000_15.12.e251784.13","unstructured":"Bennett JE . 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