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Table 2 Four cases of clinical manifestation of MFS/BBE associated with PRES

From: Posterior reversible encephalopathy as the first manifestation of Bickerstaff’s brainstem encephalitis

Age

(y/o)

Sex

(M/F)

Initial GBS (MFS/BBE) symptoms and signs

Initial PRES symptoms

HTN

MRI findings

antecedent infection

IVIG intervention

 

OAA

Mental disturbance

Weakness

Plantar reflex

53

M

+

NA

NA

Headache

(4 days after IVIG)

200/130 mmHg (4 days after IVIG)

Bilateral O-P-T

Cerebellum

Basal ganglion

Brainstem

Yes

Yes

[4]

29

F

+

+

(48 h after IVIG)

+

NA

Altered mental status

(48 h after IVIG)

Brain stem,

Bilateral F-P-O

No

Yes

[5]

54

F

+

+

(24–48 h after IVIG)

bilateral flexor

Headache

Seizure

(24–48 h after IVIG)

Bilaterally P-O

No

Yes

[10]

75

(our patient)

F

+

+

(day 8)

+

(day 6)

left extensor

Headache

Blurred vision

210/100 mmHg (day 4)

Bilateral O

Yes

URI: 14 days before symptoms onset

No

 
  1. Abbreviations: MFS Miller-Fisher syndrome, BEE Bickerstaff brainstem encephalitis, PRES posterior reversible encephalopathy syndrome, OAA ophthalmoplegia, ataxia, and areflexia, HTN hypertension, URI upper respiratory infection, O occipital lobe, P parietal lobe, T temporal lobe, F frontal lobe