Rehabilitation of a patient with overlap of acute transverse myelitis and Bickerstaff’s brainstem encephalitis: a case report

This case report describes a patient who had both Bickerstaff's brainstem encephalitis (BBE) and acute transverse myelitis (ATM), which is a rare occurrence. BBE is an inflammatory condition affecting the brainstem, while ATM affects the spinal cord. The patient initially presented with symptoms resembling Guillain-Barre syndrome (GBS), but further investigation revealed the co-occurrence of BBE and ATM. The patient underwent acute inpatient rehabilitation to regain function. Rehabilitation was effective in improving the patient's motor function and facilitating her return home with assistance. This case suggests that ATM should be considered in patients presenting with BBE and flaccid weakness.

• 1
  The patient presented with BBE and paraplegia, which was attributed to concomitant acute transverse myelitis, a presentation not previously reported.
• 2
  The patient's motor functional independence measure (FIM) scores improved significantly during inpatient rehabilitation, indicating functional improvement was possible.
• 3
  The patient's long-term functional improvement aligned more closely with that of ATM, suggesting that the overlap syndrome represents a distinct clinical variant with a different prognosis.