r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2025-30-4-22-31r-n-j-726Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSMuSK-миастения гравис у пациентки с перекрестным синдромом — энцефалит Бикерстаффа и фаринго-цервико-брахиальный вариант синдрома Гийена-БарреMuSK-myasthenia gravis in a patient with overlap syndrome — Bickerstaff encephalitis and pharyngo-cervico-brachial variant of Guillain-Barré syndromeМатвееваТ. В.MatveevaT. V.

Казань, Россия

Kazan, Russia

tanya.matveeva.40@mail.ruhttps://orcid.org/0000-0003-2561-7456ХафизоваИ. Ф.KhafizovaI. F.

Казань, Россия

Kazan, Russia

sclerdissem@mail.ruhttps://orcid.org/0009-0003-0919-1034ПоповаН. А.PopovaN. A.

Казань, Россия 

 

Kazan, Russia

p_nathali@mail.ruКазанский (Приволжский) федеральный университет, Институт фундаментальной медицины и биологииРоссияKazan (Volga Region) Federal UniversityRussian FederationКазанский (Приволжский) федеральный университет, Институт фундаментальной медицины и биологии; Городская клиническая больница № 7 им. М.Н. СадыковаРоссияKazan (Volga Region) Federal University; City Clinical Hospital No. 7Russian Federation2025041020253042231Copyright © Матвеева Т.В., Хафизова И.Ф., Попова Н.А., 20252025Матвеева Т.В., Хафизова И.Ф., Попова Н.А.Matveeva T.V., Khafizova I.F., Popova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/726

Впервые представлено клиническое наблюдение пациентки с MuSK-миастенией гравис, сочетающейся со стволовым энцефалитом Бикерстаффа + фаринго-цервико-брахиальным вариантом синдрома Гийена-Барре. Отмечены ранее не описанные и редкие симптомы при стволовом энцефалите Бикерстаффа — палинопсия, аллестезия, состояния дереализации и деперсонализации; при фаринго-цервико-брахиальном варианте синдрома Гийена-Барре — поражение структур периферического участка зрительного пути и периферического отдела автономной нервной системы. Проявлениями стволового энцефалита Бикерстаффа была выраженная сонливость, пирамидная и мозжечковая симптоматика, психические отклонения; его особенностью явилось развитие после перенесенной коронавирусной инфекции и ремиттирующее течение заболевания. Диагноз фаринго-цервико-брахиального варианта синдрома Гийена-Барре базировался на регистрации гипорефлексии, результатах электронейромиографии, повышении уровня белка в ликворе, вовлечения в процесс периферических отделов зрительного нерва и вегетативной нервной системы.

This is the fi rst clinical report of a patient with MuSK-myasthenia gravis combined with Bickerstaff ’s brainstem encephalitis and a pharyngo-cervico-brachial variant of Guillain-Barré syndrome. There were observed previously unreported and rare symptoms in Bickerstaff ’s brainstem encephalitis: palinopsia, allesthesia, derealization, and depersonalization states; in the pharyngo-cervico-brachial variant of Guillain-Barré syndrome, there was involvement of peripheral structures of the visual pathway and the peripheral autonomic nervous system. Manifestations of Bickerstaff ’s brainstem encephalitis included pronounced somnolence, pyramidal and cerebellar symptoms, and psychiatric disturbances; a notable feature was its development following a coronavirus infection and a relapsing course. The diagnosis of the pharyngo-cervico-brachial variant of Guillain-Barré syndrome was based on fi ndings such as hyporefl exia, results of electroneuromyography, elevated protein levels in cerebrospinal fl uid, and involvement of peripheral segments of the optic nerve and autonomic nervous system. 

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The authors declare that there are no conflicts of interest present.