Refractory Psychomotor Agitation Responding to Dexmedetomidine Infusion: A Rare Presentation of Bickerstaff Brainstem Encephalitis (BBE)

  
NCJ_cover.jpgBy Yohei Harada, Mhd Ezzat Zaghlouleh & Vishank Shah

First Online: 20 July 2020

Bickerstaff brainstem encephalitis (BBE) is characterized by ophthalmoplegia, blepharoptosis, facial weakness, ataxia, bulbar palsy and altered mental status (AMS) [1]. AMS is seen in all patients with BBE, specifically characterized by hypersomnolence, stupor or coma [2]. Psychomotor agitation in BBE is rare. We describe a patient with BBE that presented with severe agitation, refractory to antipsychotics and benzodiazepines with good response to dexmedetomidine needing prolonged neurocritical care with eventual good functional recovery. We also include a review of the literature describing cases of BBE with psychomotor agitation.

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