{"title":"Anti-GQ1b-Positive Bickerstaff Brainstem Encephalitis Complicated by Diffuse Hypertrophic Pachymeningitis: A Case Report.","authors":"Taiki Matsubayashi, Kaoru Morita, Jun Terai, Misako Furuki, Ayumi Uchibori, Masato Obayashi","doi":"10.2169/internalmedicine.7558-26","DOIUrl":null,"url":null,"abstract":"<p><p>A 36-year-old man developed acute progressive ataxia, an impaired consciousness, and ophthalmoplegia after an upper respiratory tract infection. A cerebrospinal fluid analysis revealed pleocytosis in the patient. Initial plain brain magnetic resonance imaging (MRI) showed no remarkable findings, whereas initial brain perfusion single-photon emission computed tomography demonstrated hyperperfusion in the brainstem. Follow-up contrast-enhanced MRI revealed diffuse dural thickening, and a histopathological examination supported the diagnosis of hypertrophic pachymeningitis. Anti-GQ1b antibodies were detected, leading to a diagnosis of Bickerstaff brainstem encephalitis (BBE). This case suggests that hypertrophic pachymeningitis may be a rare complication of BBE.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal medicine (Tokyo, Japan)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2169/internalmedicine.7558-26","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
A 36-year-old man developed acute progressive ataxia, an impaired consciousness, and ophthalmoplegia after an upper respiratory tract infection. A cerebrospinal fluid analysis revealed pleocytosis in the patient. Initial plain brain magnetic resonance imaging (MRI) showed no remarkable findings, whereas initial brain perfusion single-photon emission computed tomography demonstrated hyperperfusion in the brainstem. Follow-up contrast-enhanced MRI revealed diffuse dural thickening, and a histopathological examination supported the diagnosis of hypertrophic pachymeningitis. Anti-GQ1b antibodies were detected, leading to a diagnosis of Bickerstaff brainstem encephalitis (BBE). This case suggests that hypertrophic pachymeningitis may be a rare complication of BBE.
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