other diagnostic entities are often included in the spectrum of guillain–barré syndrome. bickerstaff's brainstem encephalitis, for instance, is part of the group of conditions now regarded as forms of miller fisher syndrome (anti-gq1b antibody syndrome), as well as a related condition labelled "acute ataxic hypersomnolence" where coordination problems and drowsiness are present but no muscle weakness can be detected. bbe is characterized by the rapid onset of ophthalmoplegia, ataxia, and disturbance of consciousness, and may be associated with absent or decreased tendon reflexes and as well as babinski's sign. the course of the disease is usually monophasic, but recurrent episodes have been reported. mri abnormalities in the brainstem have been reported in 11%.