On admission he was conscious and rational with a GCS of
15/15 and was afebrile. He had a maculo papular rash on bilateral lower limbs.
There was no lymphadenopathy or anaemia.
He had bilateral flaccid quadriplegia on admission with autonomic
involvement. Power was 0 on both upper and lower limbs with bladder and
bowel involvement. He also had bulbar palsy. His upper cranial nerves were
normal. Cerebellar functions couldn’t be assessed as patient had gross
weakness. He had a sensory level at C5 and his pectoralis jerk was exaggerated
indicating a motor level above C2. Patient was on a catheter without bladder
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sensation. There were no organomegaly or ascites. His blood pressure was
documented as 160/100 mmHg and pulse rate was 88bpm. Examination of the
respiratory system was normal with vesicular breath sounds bilaterally. There
were no added sounds or clinical evidence of a pleural effusion. After
admission he developed bilateral spastic quadriplegia.