Etiology matters for neuroprognostication: A multimodal electrophysiological investigation in a case of Bickerstaff's brainstem encephalitis.
Neurophysiol Clin
; 52(5): 398-403, 2022 Oct.
Article
em En
| MEDLINE
| ID: mdl-36210256
ABSTRACT
We report the case of a 19-year-old patient with an acute-onset non-traumatic coma. Brain MRI scan was normal, CSF showed mild pleocytosis and moderately elevated protein, and continuous EEG-monitoring was compatible with spindle-coma. Cortical somatosensory evoked potentials (SSEPs) and middle-latency auditory evoked potentials (MLAEPs) were bilaterally absent, and brainstem auditory evoked potentials suggested a brainstem dysfunction. Serum anti-GQ1b and anti-GT1a IgG antibodies positivity suggested Bickerstaff's brainstem encephalitis (BBE). The clinical and functional outcomes were favorable and normal cortical SSEPs/MLAEPs reappeared in a few weeks. Based on this report, in cases of unexplained MRI-negative coma with neurophysiological evidence of brainstem dysfunction, BBE should be eliminated before considering withdrawal of life-sustaining therapy (WLST).
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Encefalopatias
/
Encefalite
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Neurophysiol Clin
Assunto da revista:
FISIOLOGIA
/
NEUROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article