General description

Bickerstaff brainstem encephalitis is reported as a central nervous system disease characterized by impaired consciousness, external ophthalmoplegia, and ataxia. It was later discovered to involve the same anti-GQ1b antibodies as Fisher syndrome, a peripheral nerve disease characterized by external ophthalmoplegia, ataxia, and loss of tendon reflexes. Consequently, these conditions are considered to be on the same disease spectrum.

Radiographic features

An MRI reveals symmetrical involvement of the brainstem, thalamus, middle cerebellar peduncle, and cerebellum on T2WI and FLAIR imaging. Additionally, multiple foci of abnormal white matter signal intensities may also be observed in the cerebral hemispheres.