Abstract
In January, 2010, a 73-year-old man became acutely unwell with a sore throat, unsteadiness, and vomiting while visiting Bhopal, India. Within 12 hours he was unable to stand. He was admitted to a local hospital, where he was noted to have a flaccid tetraparesis. A CSF sample showed raised protein (790 mg/L) and presence of white blood cells (lymphocytes 4, polymorphonuclear cells 3), but no glucose and no organisms on Gram stain or stain for acid-fast bacilli. He was transferred to a tertiary centre in Mumbai where a tracheostomy was done and MRI of the brain showed acute encephalomyelitis of the pons, medulla, and upper cervical cord.
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