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 CASE REPORT
Year : 2021  |  Volume : 69  |  Issue : 5  |  Page : 1397--1399

A Hypopituitarism Patient with Bickerstaff's Brainstem Encephalitis Overlapped by Guillain-Barré Syndrome: A Case Report


1 First Clinical Medical School; Neurology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
2 Neurology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

Correspondence Address:
Zhi-Bing Wu
Neurology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 16 JiChang Rd, Guangzhou - 510 405
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.329589

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We present a rare case of Bickerstaff's brainstem encephalitis (BBE) overlapped with Guillain-Barré syndrome (GBS), which might be triggered by the patient's hypopituitarism condition. A 36-year-old woman with a history of hypopituitarism presented with a headache on the first day. Gradually, diplopia, ataxia, dysarthria, dysphagia, hypoesthesia, limb weakness, hypersomnolence, and respiratory muscle paralysis were developed in less than ten days. Based on brain computed tomography scan, magnetic resonance imaging scan, nerve conduction studies, cerebrospinal fluids analysis, anti-ganglioside antibodies and hormones tests, and clinical investigations, we diagnosed the patient with BBE overlapped with GBS. Treatment with corticosteroids and immunoglobulin resulted in clinical improvement. To our knowledge, this is the first case report of a hypopituitarism patient with BBE overlapped by GBS in English literature. Hypopituitarism patients have immune dysfunction. Based on previously reported autoimmune diseases associated with triggering GBS and its subtypes, hypopituitarism could be considered a noninfectious trigger.






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