标题：Miller-Fisher综合征和Bickerstaff脑干脑炎的鉴别诊断

      作者：伍思婷，石 强
    (中国人民解放军总医院海南分院神经内科，海南 三亚 572000)

      卷次： 2015年26卷16期

      【摘要】 目的 探讨Miller-Fisher综合征(MFS)和 Bickerstaff脑干脑炎(BBE)的临床特点及鉴别诊断。
方法 回顾性分析我科收治的 3例MFS和 2例BBE患者的临床资料及影像学表现。结果 MFS与BBE两
组患者均可以有脑神经、共济运动及腱反射异常。BBE组均有锥体束受损表现，头颅MRI异常1例；MFS组有
脊神经受累表现。脑脊液检查MFS组蛋白升高3例，BBE组蛋白升高1例。肌电图MFS组示神经源性损害3例，
BBE组正常；脑干听觉诱发电位MFS组正常，BBE组有听觉诱发电位异常。结论 MFS和BBE发病可能都与抗
神经节苷脂( GQ1b)抗体有关，前者主要以周围神经损伤为主，后者则以中枢神经系统受损为主，鉴别诊断主要依
靠影像学及肌电图检查。

      【关键词】 Miller-Fisher综合征；Bickerstaff脑干脑炎；鉴别诊断

      【中图分类号】 R742 【文献标识码】 A 【文章编号】 1003—6350（2015）16—2428—03


Differential diagnosis of Miller-Fisher syndrome and Bickerstaff brainstem encephalitis: an analysis of 5 cases.
WU Si-ting, SHI Qiang.
Department of Neurology, Hainan Branch, General Hospital of the People's Liberation Army,
Sanya 572000, Hainan, CHINA

【Abstract】 Objective To explore the clinical characteristics and differential diagnosis of Miller-Fisher syn-
drome (MFS) and Bickerstaff brainstem encephalitis (BBE). Methods The clinical and laboratory data of 3 patients
with diagnosis of MFS (MFS group) and 2 patients with diagnosis of BBE (BBE group) were analyzed retrospectively.
Results The patients of the two groups may have the clinical characteristics as ophthalmoplegia, ataxia and reflex
disability. All of patients in BBE group presented with positive Babinski sign, abnormal results of MRI examinations
(1 case). In MFS group, the patients showed spinal nerve involvement. CSF examination showed elevation of protein
in 3 patients from MSF group and 1 patient from BBE group. Electromyography exam suggested neurogenic damage
in all the patients of MSF group, but normal results in BBE group. Auditory evoked potential exam showed abnormal
results in BBE group. Conclusion The pathogenesis of MFS and BBE may associate with ant-iGQ1b antibody. MFS
mainly damage peripheral nerves, while BBE damage central nerves. The main identifications of BBE and MFS are
image results and electromyography exam.

      【Key words】 Miller-Fisher syndrome (MFS); Bickerstaffs brainstem encephalitis (BBE); Differential diagnosis