抗GQ1b，抗GT1a，抗GM1抗体が陽性であったBickerstaff型脳幹脳炎の1例

A Case Report of Bickerstaff's Brainstem Encephalitis with Positive Anti GQ 1 b, GT 1 a, GM 1 Ganglioside Antibodies

　Bickerstaff型脳幹脳炎において抗ganglioside抗体の出現が報告されている。今回われわれは抗GQ 1b抗体以外に抗GT 1 a，抗GM 1抗体の出現した1例を経験したので報告する。Fisher症候群での抗GT 1 a抗体の陽性例と同様に外眼筋麻痺が強く，抗GT 1 a抗体が神経症状に関与している可能性が考えられた。一方，末梢神経伝導速度は正常で，conduction blockもみられなかった。またCampylobacter jejuniの先行感染はなくGuillain-Barré症候群の合併は否定的でありGM 1抗体との関連は不明であった。

Patient was an 18-year-old female student. After she had symptoms of common cold for 3 days, she de-veloped somnolence, diplopia, dysarthria, urinary dis-turbance and ataxia. On admission neurological exami-nation revealed coma with mydriasis, ophthalmoplegia, ptosis and weakness of the upper limbs. Light reflex, corneal reflex and oculocephalic test were all negative. Deep tendon reflexes were brisk and extensor toe signs were positive bilaterally. She did not have nuchal rigidity. Laboratory test revealed normal cere-brospinal fluid with negative myelin basic protein.