top of page


A 54 year-old male is admitted with progressive dysarthria, diplopia, dysphagia, unsteadiness and weakness in all four limbs. His symptoms started around 2 months ago. On examination, he is alert and orientated. He has restricted eye movements in all directions of gaze, bilateral facial weakness, dysarthria, brisk reflexes in all four limbs and gait ataxia. Blood tests show white cell count of 9.3 x 109/L and CRP level of 14 mg/L. MRI T2 FLAIR and T1 contrast of the brain are shown below. CSF analysis shows white cell count of 23/mm3 (70% lymphocytes) and protein concentration of 0.86 g/L. CSF cytology reveal mature T-lymphocytes. What is the most likely diagnosis?


A. Bickerstaff's encephalitis


C. CNS tuberculosis

D. Listeria rhombencephalitis

E. Neurosarcoidosis

bottom of page