title: Weston-Hurst syndrome: a rare fulminant form of acute disseminated encephalomyelitis (ADEM).
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.
authors: Department of Neurology, PIMS, Islamabad, Pakistan.
authors: Sumaira
authors: S
authors: Nabi
authors: Department of Neurology, PIMS, Islamabad, Pakistan.
authors: Mazhar
authors: M
authors: Badshah
authors: Department of Neurology, PIMS, Islamabad, Pakistan.
authors: Shahzad
authors: S
authors: Ahmed
authors: Department of Neurology, PIMS, Islamabad, Pakistan.
authors: Ali Zohair
authors: AZ
authors: Nomani
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D004684:Leukoencephalitis, Acute Hemorrhagic / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D011782:Quadriplegia / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome