探讨抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征。

回顾分析2016年2月至2019年5月经广东三九脑科医院神经内科确诊的3例抗GQ1b抗体阳性的Bickerstaff脑干脑炎患者的临床资料，总结抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征，并复习相关文献。

患者均为女性，年龄分别为16岁、19岁、49岁，发病前均有感染病史。3例均以共济失调起病，2例起病时伴有四肢无力，1例加重后出现意识障碍、四肢无力。3例患者均有眼肌麻痹，2例患者锥体束征阳性。3例患者抗GQ1b抗体均为阳性，头颅磁共振成像平扫及强化扫描未见明显异常，2例患者肌电图诱发电位检查异常，1例患者检查正常。

Bickerstaff脑干脑炎临床上主要表现为急性眼肌麻痹、共济失调，可伴有意识障碍和(或)锥体束征阳性的综合征，结合血清抗体、影像学及神经电生理检查方能正确诊断。

To explore the diagnostic features of Bickerstaff brainstem encephalitis (BBE) with positive anti-GQ1b antibody.

The clinical data of 3 BBE cases with positive anti-GQ1b antibody diagnosed by the Neurology Department of Guangdong Sanjiu Brain Hospital from February 2016 to May 2019 were retrospectively analyzed. Diagnostic features of BBE with positive anti-GQ1b antibody were summarized, and relevant literatures were reviewed.

The 3 patients were all female, with the age of 16, 19, 49 years old respectively, and all of them had a history of infection before the onset. All 3 cases had onset of ataxia, 2 cases had limb weakness at the onset, and 1 case developed consciousness disorder and limb weakness after aggravation. On physical examination, 3 patients had ophthalmoplegia, and 2 patients had positive pyramidal tract signs. Auxiliary examination: 3 patients presented positive of anti-GQ1b antibodies, 3 patients showed no obvious abnormalities in brain magnetic resonance imaging (MRI) scan and enhancement, 2 patients had abnormal electromyogram evoked potentials, and 1 patient was normal.

BBE is a syndrome that mainly manifests as acute ophthalmoplegia, ataxia accompanied by disturbance of consciousness and/or positive pyramidal tract signs. Thorough understanding of associated clinical features and serum antibody, imaging and nerve electrophysiological examination are helpful in achieving at the correct diagnosis.