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Case Reports
. 2016 Oct 19:2016:bcr2016217215.
doi: 10.1136/bcr-2016-217215.

Weston-Hurst syndrome: a rare fulminant form of acute disseminated encephalomyelitis (ADEM)

Sumaira Nabi  1 , Mazhar Badshah  1 , Shahzad Ahmed  1 , Ali Zohair Nomani  1
Affiliations
Case Reports

Weston-Hurst syndrome: a rare fulminant form of acute disseminated encephalomyelitis (ADEM)

Sumaira Nabi et al. BMJ Case Rep. .

Abstract

A 25-year-old Pakistani woman presented to the emergency department with a 2-day history of rapidly progressive tetraplegia followed by sudden loss of consciousness. This was preceded by an upper respiratory tract infection. On examination, she was deeply comatose with a GCS of 3/15 and intact brainstem reflexes. She was in respiratory distress, and an endotracheal tube had been passed. She had flaccid quadriplegia with depressed deep tendon reflexes and upgoing plantar response. Her MRI brain with contrast showed extensive brainstem involvement with haemorrhagic foci along with signal changes in the corpus callosum. The patient was put on a respirator. She was given IV methyl prednisolone, and later on 5 sessions of plasmapheresis were performed. After 3 months, the patient gradually recovered and started communicating. Her motor power had improved to 2/5 in her arms and 1/5 in the lower extremities. She was then discharged for further rehabilitation at home.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Non-contrast enhanced CT brain (axial image) revealed hypodense signals throughout the brainstem.
Figure 2
Figure 2
Non-contrast enhanced CT brain (axial image) revealed hypodense signals throughout the brainstem.
Figure 3
Figure 3
MRI brain T2WI (sagittal image) showed extensive brainstem involvement with hyperintense signals.
Figure 4
Figure 4
MRI brain T1WI (axial image) showed haemorrhagic foci in the brainstem.
Figure 5
Figure 5
MRI brain T1WI (axial image) showed haemorrhagic foci in the corpus callosum.
See this image and copyright information in PMC

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