RT Book, Section A1 Choi, H. Alex A1 Ko, Sang-Bae A1 Lee, Kiwon A2 Lee, Kiwon SR Print(0) ID 1101642931 T1 Inflammatory and Demyelinating Central Nervous System Diseases T2 The NeuroICU Book YR 2012 FD 2012 PB McGraw-Hill Education PP New York, NY SN 9780071636353 LK neurology.mhmedical.com/content.aspx?aid=1101642931 RD 2024/11/03 AB A 60-year-old man with a history of hypertension is admitted with several days of fever and generalized weakness. He complains of diplopia and anorexia and is found to have a low-grade fever of 100.1°F. Over the next few days he clinically deteriorates, developing progressive encephalopathy, worsening right arm weakness, bulbar weakness, and an inability to walk. A head computed tomography (CT) shows nonspecific white matter changes. He is intubated for airway protection and transferred to the neurologic intensive care unit (NICU). On presentation, his examination shows vital signs: temperature 100.2°F, HR 90 bpm, BP 130/90 mm Hg. He has intact cranial nerves except for an absent gag reflex. Motor examination reveals increased tone throughout, extensor posturing of the left arm, flexor posturing of the right arm, and no response in the lower extremities.