Neurologic manifestations of heatstroke at the Mecca pilgrimage

We analyzed the extent, pattern, and evolution of neurologic dysfunction in 87 patients with heatstroke at the Mecca pilgrimage. Disturbance of consciousness and constricted pupils were seen in all patients. Deep coma, areflexia, and absent brainstem reflexes were seen in 25 patients (29%). Automatic complex movements (chewing, swallowing, and lip smacking) were seen in 17 patients (30%). Body shivering during cooling occurred in six patients (7%). Recovery was uncomplicated in 75 patients (87%). Two (2%) recovered but developed pancerebellar syndrome. Ten patients (11%) died.