Magnetic resonance imaging differential diagnosis of brainstem lesions in children

Figure 11 Anti-GQ1b antibody syndrome, Bickerstaff brainstem encephalitis type. A 8-year-old girl with ataxia, diplopia and drowsiness. A tumor-like left diencephalo-mesencephalic T2 hyperintense lesion (A-C), shows a normal metabolic profile at MR spectroscopy (upper inlet in A) and inhomogeneous peripheral and spotty enhancement after contrast agent administration (upper inlet in B). Net reduction in size of the lesion (D-F) two weeks after corticosteroid treatment and the identification of anti-GQ1b autoantibodies in the CSF guide towards the diagnosis of brainstem encephalitis. MR: Magnetic resonance. CSF: Cerebro-spinal fluid.