BACKGROUND: Bickerstaff's brainstem encephalitis (BBE), together with Miller 
Fisher syndrome (MFS) and Guillain-Barré syndrome (GBS) were considered to form 
a continuous clinical spectrum. An anti-GQ1b antibody syndrome has been proposed 
to underlie the common pathophysiology for the three disorders; however, other 
studies have found a positive anti-GM1 instead of anti-GQ1b antibody.
CASE PRESENTATION: Here we report a 20-year-old male patient with overlapping 
BBE, MFS and GBS. The patient had a positive family history of bronchial asthma 
and had suffered from the condition for over 15 years. He developed BBE symptoms 
nine days after an asthma exacerbation. During the course of illness, he had 
significantly elevated IgE levels in both serum and cerebrospinal fluid. 
Serologic analysis of antibodies against ganglioside complexes (anti-GDIa, 
anti-GDIb, anti-GM1, anti-GM2, anti-GM3, anti-GQIb and anti-GTIb antibodies) 
showed negative results.
CONCLUSIONS: Since asthma has recently been related to autoimmune disease, our 
case supports an autoimmune mechanism underlying the clinical spectrum composed 
of BBE, MFS and GBS. However, contrary to a proposed anti-GQ1b antibody 
syndrome, we would suggest that pathogenesis of this clinical spectrum is not 
limited to anti-ganglioside antibodies.