ABSTRACT
A 30-year-old woman was brought to the emergency department after an episode of collapse while at home. Her sister witnessed the episode and described the patient suddenly collapsing to the floor followed by 5–10 minutes where her limbs were shaking. She had bitten her tongue and been incontinent of urine. The seizure self-terminated shortly before an ambulance arrived. She was drowsy for approximately 15 minutes after regaining consciousness. The patient seemed unable to vocalise on arrival to the emergency department and was communicating via gestures and nodding or shaking her head. She did not recall the event or post-ictal phase. She denied prodromal symptoms prior to her collapse. She had two identical episodes within the last fortnight, both of which left her unable to speak for several hours, followed by a period of speech disturbance. She denied any recent headaches, fevers or cough. She admitted to recent episodes of auditory hallucinations. She had no symptoms of pharyngitis, odynophagia, dysphagia or shortness of breath. She had no past medical or surgical history and had taken no regular or over-the-counter medications in recent months. Her parents and siblings were well. She lived with her sister and was an art student. She denied smoking or recreational drug use. She drank approximately 14 units of alcohol per week. She had one regular male sexual partner and used barrier contraception. She was born in the United Kingdom and travelled to Bangladesh every summer; she had returned from a trip to Bangladesh 6 weeks earlier.
