Rehabilitation of Bickerstaff's Brainstem Encephalitis with Guillain-Barre Syndrome: A case report

ABSTRACT

We reported a 32-year-old man diagnosed as Bickerstaff's brainstem encephalitis with Guillian-Barre syndrome. After plasmapheresis, his consciousness and respiratory function and motor strength improved. He was discharged without rehabilitation treatment and could perform activities of daily living independently on wheel chair level. For reducing cocontraction of lower extremity muscles, neuromuscular reeducation using EMG biofeedback was performed after admission. After a month of treatment, gait pattern was improved. He received rehabilitative managements such as pool therapy with gait training and improved to 4/5 grade at proximal lower extremities, but the endurance and the quality for his walking was poor because of the cocontraction of muscles in lower extremities. EMG biofeedback for the neuromuscular reeducation leading to each muscle's isolated movements was done. After 2-month rehabilitation, he could walk over 20 meters even level independently without walking aids. This case could be a good model for the effective neuromuscular reeducation.