Endgames Spot Diagnosis

A returning traveller with epilepsy

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4664 (Published 02 November 2017) Cite this as: BMJ 2017;359:j4664
  1. Harshavardhan Bandi, clinical fellow,
  2. Rizwan Khan, consultant acute physician,
  3. Vinod Dibbur, consultant acute/renal physician
  1. Great Western Hospitals NHS Foundation Trust, Acute Medicine, Swindon, UK
  1. Correspondence to H Bandi h.bandi{at}nhs.net

A 35 year old vegetarian Indian woman who had been living in the UK for three years presented in the emergency department with a first episode of seizure after a trip to India. She had undergone total thyroidectomy for toxic nodular goitre in the UK earlier in the year and was taking calcium supplements. She had experienced vague abdominal discomfort two weeks before the seizure. The patient’s grandmother, whom the patient visited during her trip to India, had experienced delirium, dizziness, and headaches two months before the patient’s visit. These symptoms self resolved and were not investigated. In addition, the patient’s husband also experienced vague abdominal discomfort similar to the patient’s, two weeks before she presented. The woman had a magnetic resonance …

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