The objective of this case report is to present a case of acute immune mediate demyelinating polyneuropathy (AIDP) triggered by an intracranial hemorrhage (ICH), which was identified by early loss of brainstem reflexes.

AIDP is a phagocytic attack on Schwann cells and/or myelin in the peripheral nervous system, resulting in decreased nerve conduction and acute denervation. AIDP has rarely been observed with intracranial hemorrhage or ischemic stroke. Moreover, a diagnosis of fulminant AIDP with a clinical picture of brain death has only been previously described in few case reports, and never in the setting of intracranial hemorrhage.

This is a case report, where we describe a patient who underwent ICH evacuation which progressed to fulminant AIDP with loss of brainstem reflexes.

While the patient's apparent comatose state and absent brainstem reflexes was suspicious for brain death, the severity of her hemorrhage was not consistent with it. Our diagnosis of fulminant AIDP was based on a combination of neurological examination, lumbar puncture and EMG studies and allowed for effective treatment and recovery of a patient showing signs of apparent brain death.