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Acute hemorrhagic leukoencephalitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Acute hemorrhagic leukoencephalitis (AHL, or AHLE), also known as acute necrotizing encephalopathy (ANE), acute hemorrhagic encephalomyelitis (AHEM), acute necrotizing hemorrhagic leukoencephalitis (ANHLE), Weston-Hurst syndrome, or Hurst’s disease, is a hyperacute and frequently fatal form of ADEM. AHL is relatively rare (less than 100 cases have been reported in the medical literature as of 2006),[1] it is seen in about 2% of ADEM cases, and is characterized by necrotizing vasculitis of venules and hemorrhage, and edema.[2] Death is common in the first week[3] and overall mortality is about 70%,[1] but increasing evidence points to favorable outcomes after aggressive treatment with corticosteroids, immunoglobulins, cyclophosphamide, and plasma exchange. About 70% of survivors show residual neurological deficits,[2] but some survivors have shown surprisingly little deficit considering the magnitude of the white matter affected.[3] This disease has been occasionally associated with ulcerative colitis and Crohn’s disease, septicemia associated with immune complex deposition, methanol poisoning, and other underlying conditions.

References

  1. 1.0 1.1 Davies NW, Sharief MK, Howard RS (2006). “Infection-associated encephalopathies: their investigation, diagnosis, and treatment”. J. Neurol. 253 (7): 833–45. doi:10.1007/s00415-006-0092-4. PMID 16715200. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 Stone MJ, Hawkins CP (2007). “A medical overview of encephalitis”. Neuropsychol Rehabil. 17 (4–5): 429–49. doi:10.1080/09602010601069430. PMID 17676529.
  3. 3.0 3.1 Archer H, Wall R (2003). “Acute haemorrhagic leukoencephalopathy: two case reports and review of the literature”. J. Infect. 46 (2): 133–7. doi:10.1053/jinf.2002.1096. PMID 12634076. Unknown parameter |month= ignored (help)

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