Acute Hemorrhagic Leukoencephalitis (Hurst Disease) Secondary to H1N1
in a Child - A Story of Full Recovery from Qatar, A Case Report
Khair, et al. J Neurol Disord 2015, 3:3
Khair AM*, Elsotouhy A, Batool M and Elsaid M
Hamad Medical Corporation, Department of Pediatrics, Section of Pediatric Neurology, P.O. Box 3050, Doha, Qatar
Abstract
Background: Hurst disease is the rarest yet the most fatal form of acute demyelinating encephalomyelitis.
There around 100 cases around the world, 10 of them are pediatric patients. The disease is quite severe in course
and aggressive therapy is crucial to help improving the outcome. We are reporting a rather successful story of early
recognition and treatment of young toddler with using all lines of known therapies simultaneously and aggressively.
Case report: We are reporting 2 ? years old girl who was previously healthy. She has some viral prodromal
illness ended by severe encephalopathy. She has found to have novel H1N1 infection. Early plasma exchange and
therapeutic hypothermia have been simultaneously utilized. There was obvious significant fast improvement in clinical
status thereafter.
Discussion: Immune therapy is advised in treating Hurst disease. One trial of hypothermia has been suggested in
one case report. However, Combination of early use of plasma exchange and therapeutic hypothermia has not been
reported in literature up to our knowledge. Our patient showed impressive clinical progress following these rarely used
procedures.
Conclusion: Recognition of autoimmune encephalitis especially the most severe forms is a must. If the patient shows
enough clinical and radiological signs suggestive of Hurst disease, then aggressive immunotherapy and therapeutic
hypothermia should be considered. A more favorable outcome might be reached using these therapies simultaneously.
