ABSTRACT
A 43-year-old man presented to the emergency department while in police custody, having developed painful, bilateral wrist spasms shortly after being arrested. He reported experiencing several similar episodes with spasms of the wrist and forearms, associated with perioral tingling over recent months. The episodes usually coincided with episodes of anxiety or distress. He had been experiencing headaches regularly over the past 5 years. On direct questioning, he also described recent symptoms of polydipsia and polyuria, drinking around 4 litres of water per day and waking to urinate 5–10 times per night. He denied any other medical history and took no regular medications. He was a current smoker of 20 cigarettes daily and drank around 60 units of alcohol per week. He admitted to daily cannabis use and occasional cocaine use.
