Singh Lovelina, Acharya Shweta S, Arumugam Praveen, Shetti Suraj, Sharan Shalini
Neurology, Max Super Speciality Hospital, New Delhi, IND.
Internal Medicine, Max Smart Super Speciality Hospital, New Delhi, IND.
Cureus. 2024 Jul 18;16(7):e64857. doi: 10.7759/cureus.64857. eCollection 2024 Jul.
Hurst disease, or Weston-Hurst syndrome, or acute hemorrhagic encephalomyelitis (AHEM), is an infrequent condition that usually gets provoked after a viral infection (respiratory tract infection) or, as reported in many case reports, post-vaccination. Hurst disease is a difficult-to-diagnose condition because it mimics common presentations such as stroke, decreased or loss of consciousness, brain abscess, and seizures, making clinical diagnosis challenging. Radiological imaging, such as magnetic resonance imaging (MRI) of the brain with diffusion-weighted imaging, now serves as the primary modality to identify such conditions, despite its lack of specificity. The treating doctor needs to do an in-depth analysis of the patient's history, as this carries a very high mortality rate. We hereby discuss a case that presented with seizures and deteriorating Glasgow Coma Scale (GCS) score, on imaging revealed posterior circulation acute hemorrhagic leukoencephalitis (AHLE)/AHEM, therein treated with steroids, plasmapheresis resulted in a good outcome implicating, early detection and timely management can reduce the mortality due to this condition.
赫斯特病,或韦斯顿 - 赫斯特综合征,或急性出血性脑脊髓炎(AHEM),是一种罕见病症,通常在病毒感染(呼吸道感染)后诱发,或者如许多病例报告中所报道的,在接种疫苗后诱发。赫斯特病是一种难以诊断的病症,因为它会模仿中风、意识减退或丧失、脑脓肿和癫痫发作等常见症状,这使得临床诊断具有挑战性。尽管缺乏特异性,但诸如带有弥散加权成像的脑部磁共振成像(MRI)等放射学成像现在是识别此类病症的主要方式。主治医生需要对患者病史进行深入分析,因为这种病的死亡率非常高。我们在此讨论一个病例,该病例表现为癫痫发作且格拉斯哥昏迷量表(GCS)评分恶化,影像学检查显示为后循环急性出血性白质脑炎(AHLE)/AHEM,在该病例中使用类固醇进行治疗,血浆置换取得了良好效果,这表明早期检测和及时处理可以降低这种病症导致的死亡率。