Bickerstaff's brain stem encephalitis after a motor vehicle crash

Abstract

Bickerstaff’s brain stem encephalitis (BBE) is a monophasic, postinfectious disorder with acute ophthalmoparesis and ataxia. 1 It is distinguished from Miller-Fisher syndrome (MFS) by the presence of consciousness disturbance or pyramidal signs including hyperreflexia or pathologic reflexes. 2 The cause of BBE is unknown, but because prior infection is frequently associated with BBE, as in the case of MFS, autoimmune mechanisms produced by viral or bacterial infections may function in its pathogenesis. 3 A case of BBE has been reported during pregnancy, 4 but until recently no report has been issued on BBE occurring after a trauma caused by a traffic accident. We describe the first case of BBE after a traffic accident supported by serial magnetic resonance imaging (MRI) investigations.