Author: Girish Boggaram / Editor: Michael John Stewart / Reviewer: Chris Wearmouth, Kathryn Boyle / Codes: IC3, NeuP3, SLO1, SLO2 / Published: 02/02/2024

A 27-year-old man is brought to the Emergency Department (ED) by ambulance after having two seizures. He has no known health problems. The second seizure was tonic-clonic, witnessed by paramedics and terminated by IV lorazepam. He speaks little English having immigrated from India a year ago, however, his friend says he is “not right”. He is drowsy but follows simple commands.

Otherwise, the examination is unremarkable and his bloods including glucose are normal apart from a mildly raised lactate.

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