A flaccid tetraparesis in Bickerstaff's brainstem encephalitis (BBE) is presumed 
to be a sign of overlapping Guillain-Barré syndrome (GBS). In addition, BBE and 
Fisher syndrome, which are clinically similar and are both associated with the 
presence of the immunoglobulin G anti-GQ1b antibody, represent a specific 
autoimmune disease with a wide spectrum of symptoms that include ophthalmoplegia 
and ataxia. A 2-year-old boy presented with rapidly progressive ophthalmoplegia, 
ataxia, hyporeflexia, weakness of the lower extremities, and, subsequently, 
disturbance of consciousness. He experienced bronchitis with watery diarrhea and 
had laboratory evidence of recent infection with Epstein-Barr virus (EBV). He 
was diagnosed as having overlapping GBS and BBE associated with EBV and received 
treatment with a combination of immunoglobulin and methylprednisolone, as well 
as acyclovir, and had recovered completely after 3 months. In addition, he has 
not experienced any relapse over the past year. We suggest that combinations of 
symptoms and signs of central lesions (disturbance of consciousness) and 
peripheral lesions (ophthalmoplegia, facial weakness, limb weakness, and 
areflexia) are supportive of a diagnosis of overlapping GBS and BBE and can be 
helpful in achieving an early diagnosis, as well as for the administration of 
appropriate treatments.