Acute hemorrhagic leukoencephalitis (AHLE) is a rare but fulminant variant of acute disseminated encephalomyelitis, an uncommon immune-mediated demyelinating disorder. We report a case of AHLE in a 27-year-old pregnant woman who presented with acute onset of fever, aphasia, and a generalized seizure, followed by rapid neurological deterioration. The hallmark neuroimaging findings made the prompt diagnosis. The patient responded dramatically to high-dose corticosteroid therapy, with full neurological recovery. She subsequently delivered a healthy full-term infant and remained asymptomatic at one-year follow-up.
