Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of Bickerstaff brainstem encephalitis with transient reflex myoclonus

Ryusuke Takaki, M.D.1)2), Takamura Nagasaka, M.D., Ph.D.1), Yumi Suwa, M.D.1), Mai Tsuchiya, M.D.1), Kishin Kho, M.D., Ph.D.1) and Yoshihisa Takiyama, M.D., Ph.D.1)

1)Department of Neurology, Faculty of Medicine, University of Yamanashi
2)Department of Neurology, Iida Hospital

A 33-year-old woman was admitted due to disturbance of consciousness, dysarthria, dysphagia, sensory disturbances and weakness of the left upper limb after mycoplasma infection. She was treated with intravenous immunoglobulin and intravenous high-dose methylprednisolone as Bickerstaff brainstem encephalitis (BBE). On the 15th hospital day, reflex myoclonus appeared on her face, neck, body and limbs induced by techniques of jaw jerk reflex and patellar tendon reflex. The myoclonus was disappeared after two weeks in accordance with improvement of BBE. The transient reflex myoclonus may be originated from brainstem lesion which was affected by BBE. Reflex myoclonus is thought to be rare symptom in patient with BBE.
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(Authors have received and achieved patient consent for video recording and publication.)
Mov. 1@Reflex myoclonus on the 15th hospital day. Reflex myoclonus can be observed on her body and limbs induced by technique of patellar tendon reflex. Myoclonus is absent with technique of biceps muscle tendon reflex.
Mov. 2@Reflex myoclonus on the 15th hospital day. Reflex myoclonus can be observed on her face, neck, body and limbs induced by technique of jaw jerk.
Full Text of this Article in Japanese PDF (488K)

(CLINICA NEUROL, 57: 395|398, 2017)
key words: myoclonus, reflex myoclonus, Bickerstaff brainstem encephalitis, anti-GQ1b antibody, mycoplasma

(Received: 1-Mar-17)