Anti-GQ1b-Positive Bickerstaff Brainstem Encephalitis Complicated by Diffuse Hypertrophic Pachymeningitis: A Case Report
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.
Related
- Beyond the Classic Triad: A Case of GQ1b Antibody-Positive Bickerstaff Brainstem Encephalitis Overlap Syndrome
- Bickerstaff Brainstem Encephalitis with a Decorticate-like Posture, Involuntary Movements, Impaired Visual Acuity, and Prolonged Motor Disability
- Normal Early Investigations Do Not Exclude Bickerstaff Brainstem Encephalitis: Highlighting Diagnostic and Treatment Pitfalls
- Insufficient Dural Thickness Recovery in Acute Treatment Predicts Subsequent Relapses in Idiopathic Hypertrophic Pachymeningitis
- Hypertrophic obstructive cardiomyopathy complicated by severe midventricular obstruction treated with percutaneous transluminal septal myocardial ablation using simultaneous contrast imaging with left ventriculography and coronary angiography: a case report
BibTeX
@article{matsubayashi2026antigq1bpositive,
title = {{Anti-GQ1b-Positive Bickerstaff Brainstem Encephalitis Complicated by Diffuse Hypertrophic Pachymeningitis: A Case Report}},
author = {Taiki Matsubayashi and Kaoru Morita and Jun Terai and Misako Furuki and Ayumi Uchibori and Masato Obayashi},
journal = {Internal Medicine},
year = {2026},
month = oct,
doi = {10.2169/internalmedicine.7558-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7558-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Anti-GQ1b-Positive Bickerstaff Brainstem Encephalitis Complicated by Diffuse Hypertrophic Pachymeningitis: A Case Report
AU - Taiki Matsubayashi
AU - Kaoru Morita
AU - Jun Terai
AU - Misako Furuki
AU - Ayumi Uchibori
AU - Masato Obayashi
PY - 2026
DA - 2026/10/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.7558-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7558-26/_article
AB - 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.
SN - 1349-7235
SN - 0918-2918
ER -