Is there an autoimmune encephalitis-like brain metabolism pattern in patients with Bickerstaff brainstem encephalitis?

Authors

  • Jesus Ramírez-Bermudez Department of Neuropsychiatry, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0003-2879-5258
  • Javier Andrés Galnares-Olalde Department of Neuromuscular Diseases, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0003-3004-6221
  • Alexis García-Sarreón Department of Neurology, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery
  • Karla Rodríguez-Jiménez Department of Neurology, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0002-6717-5927
  • Sara Edith Mireles-Hernández Department of Neurology, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0001-8639-9750
  • Victoria Martínez-Ángeles Department of Neuropsychiatry, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0001-7793-6956
  • Nora Estela Kerik-Rotenberg Department of Nuclear Medicine, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0002-9924-5520
  • Iván Meneses-Díaz Department of Nuclear Medicine, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery
  • Emilly Alejandra Cortés-Mancera Department of Nuclear Medicine, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery
  • Fabio Andrés Sinisterra-Solis Department of Nuclear Medicine, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery
  • Edwin Steven Vargas-Cañas Department of Neuromuscular Diseases, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0001-7156-8275
  • Juan Carlos López-Hernández Department of Neuromuscular Diseases, Manuel Velasco Suárez National Institute of Neurology and Neurosurgery https://orcid.org/0000-0003-3419-5160

DOI:

https://doi.org/10.31157/an.v28i3.411

Keywords:

autoimmune, Encephalitis, Bickerstaff, PET

Abstract

Background: Brain 18 FDG PET is very useful in the diagnosis of autoimmune encephalitides against post-synaptic receptors. However, little is known about the metabolic changes in other autoimmune encephalitides, such as Bickerstaff stem encephalitis (BBE).

Objective: to report the case of a patient with BBE with an 18 FDG PET study and to review the literature.

Results: A 20-year-old man with no relevant history presented to the emergency department due to a clinical picture of 7 days of evolution, characterized by non-painful distal paresthesias in the 4 extremities, diplopia, instability on gait and dysphagia. On the day of his hospital stay, he presented alterations in his awake state. The clinical diagnosis of Bikerstaff's stem encephalitis was made. In his paraclinical tests, the cerebrospinal fluid was normal. He received treatment with human immunoglobulin (2 grams/kg) for 5 days. An 18 FDG PET study reported hypermetabolism in the putamen and bilateral caudate nucleus and bilateral occipital hypometabolism.

Conclusion: brain 18-FDG PET may be a subrogate marker for understanding CNS compromise in BBE.

References

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Additional Files

Published

2022-09-07

How to Cite

Ramírez-Bermudez, J., Galnares-Olalde, J. A., García-Sarreón, A., Rodríguez-Jiménez, K., Mireles-Hernández, S. E., Martínez-Ángeles, V., Kerik-Rotenberg, N. E., Meneses-Díaz, I., Cortés-Mancera, E. A., Sinisterra-Solis, F. A., Vargas-Cañas, E. S., & López-Hernández, J. C. (2022). Is there an autoimmune encephalitis-like brain metabolism pattern in patients with Bickerstaff brainstem encephalitis?. Archivos De Neurociencias, 28(3). https://doi.org/10.31157/an.v28i3.411

Issue

Vol. 28 No. 3 (2023)

Section

Case report

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Copyright (c) 2022 Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez

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September 2022-present © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.

January-September 2022 © The authors. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.

January 2014-December 2021 © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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