Author: Jacqueline Eleonora Ek / Editor: Nick Tilbury / Codes: GP9, MHP3, NeuC2, NeuP2, SLO1, SLO4, SLO6Published: 08/02/2021

A 25-year-old female with no past medical history, on oral contraceptive tablets, presents to your Emergency Department with a two-day history of headache, diarrhoea, vomiting, fatigue, and sending incoherent text messages to her friends.

She was seen the day before by her GP who encouraged oral fluids and over-the-counter analgesia for suspected viral gastroenteritis. 

Her Initial observations are all normal

Examination findings are as follows:

  • Chest: clear
  • Abdomen: soft, mild generalised tenderness
  • Lower limbs: no signs of deep vein thrombosis, no oedema.
  • Neurological exam: cranial nerves 1-12 intact, upper and lower limb power 5/5 and sensation grossly in-tact, No cerebellar signs, normal gait

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