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Cho, Park, Kim, Joo, Park, and Kim: Prolonged Comatose State Followed by Rapid Recovery in a Patient with Bickerstaff’s Brainstem Encephalitis
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Korean J Community Nutr 2013;15(1):30-33.

Published online: 19 January 2013

DOI: https://doi.org/10.14253/kjcn.2013.15.1.30

Prolonged Comatose State Followed by Rapid Recovery in a Patient with Bickerstaff’s Brainstem Encephalitis

Kee-Yong Cho1, Young-Eun Park1, 2, Jong-Kuk Kim3, Jae Hyung Joo4, Kyu-Hyun Park1, 2, Dae-Seong Kim1, 2

1Department of Neurology, Pusan National University School of Medicine, Busan, Korea

2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea

3Department of Neurology, Dong-A University College of Medicine, Busan, Korea

4Department of Neurology, Parkwonwuk Hospital, Busan, Korea

Address for correspondence; Young-Eun Park Department of Neurology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 602-739, Korea Tel: +82-51-240-7819 Fax: +82-51-245-2783 E-mail: yepark407@gmail.com

Received 2 November 20127 January 2013       Accepted 21 February 2013

Copyright © 2013 Journal of the Korean Society of Community Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords: Bickerstaff’s, brainstem encephalitis, Coma, Immunotherapy

REFERENCES

1.Bickerstaff ER. Brainstem encephalitis: further observations on a grave syndrome with benign prognosis. Br Med J. 1957. 1:1384–1387.
2.Yuki N., Sato S., Tsuji S., Hozumi I., Miyatake T. An immunologic abnormality common to Bickerstaff’s brainstem encephalitis and Fisher’s syndrome. J Neurol Sci. 1993. 118:83–87.
3.Odaka M., Yuki N., Yamada M., Koga M., Takemi T., Hirata K, et al. Bickerstaff’s brainstem encephalitis: clinical features of 62 cases and a subgroup associated with Guillain-Barre syndrome. Brain. 2003. 126:2279–2290.
4.Yuki N. Fisher syndrome and Bickerstaff’s brainstem encephalitis. J Immunol. 2009. 215:1–9.
5.Kang BG., Lim JG., Kim KD., Sohn SI., Jung DK., Cho YW, et al. A case of Bickerstaff’s brainstem encephalitis with an overlap of Guillain-Barre syndrome. J Korean Neurol Assoc. 2002. 56:561–563.
6.Susuki K., Johkura K., Yuki N., Kuroiwa Y. Clinical deterioration in Bickerstaff’s brainstem encephalitis caused by overlapping Guillain-Barre syndrome. J Neurol Sci. 2003. 211:89–92.
7.Umapathi T., Tan EY., Kokubun N., Verma K., Yuki N. Non-demyelinating, reversible conduction failure in Fisher syndrome and related disorders. J Neurol Neurosurg Psychiatry. 2012. 83:941–948.
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Table 1.
Data of nerve conduction studies
Motor nerves 1st exam 2nd exam (after 3 months)
NCV (m/s) Amplitude (mV) NCV (m/s) Amplitude (mV)
Median nerve
Terminal latency 3.75 6.7 3.80 6.0
Wrist-elbow 43.5 6.0 48.2 5.7
Elbow-axilla 47.4 6.2 46.7 5.7
F-latency 32.9 28.2
Ulnar nerve
Terminal latency 2.67 7.4 2.67 11.1
Wrist-elbow 72.0 5.0 55.7 8.5
Across elbow 50.9 4.9 70.1 8.4
Elbow-axilla 52.9 4.6 65.8 7.8
F-latency 29.6 28.1
Tibial nerve (R/L)
Terminal latency 3.80/4.42 13.7/16.1 3.79/3.67 13.5/14.9
Ankle-popliteal fossa 40.7/39.6 13.1/17.8 40.0/35.3 13.1/14.0
F-latency 51.1/47.8 48.3/47.8
Proneal nerve (R/L)
Terminal latency 3.95/4.50 5.9/6.4 4.03/4.00 5.8/6.0
Ankle-fibular head 46.7/40.5 5.2/4.1 41.0/40.2 5.1/5.2
Fibular head-Knee 50.0/50.0 4.8/4.6 42.1/50.0 4.8/5.0
F-latency 49.8/43.5 50.6/45.9
Sensory nerves NCV (m/s) Amplitude (µV) NCV (m/s) Amplitude (µV)
Median nerve
Finger-wrist NP 35.6 5.5
Palm-wrist NP 29.3 10.6
Wrist-elbow NP 31.8 3.7
Elbow-axilla NP 56.5 13.8
Ulnar nerve
Finger-wrist NP NP
Wrist-elbow NP NP
Elbow-axilla NP NP
Superficial peroneal (R/L) NP/NP NP/31.3 NP/2.7
Sural (R/L) NP/NP NP/NP

NCS; nerve conduction study, NCV; nerve conduction velocity, NP; no potential.

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