ABSTRACT
A 35-year-old woman attended hospital giving a 2-day history of feeling unwell with intermittent frontal headaches, nausea and generalised weakness. She had vomited once that day. She complained of back and neck pain but denied photophobia. Her past history included depression, bipolar affective disorder and menorrhagia. She was prescribed regular lithium but admitted that she did not adhere to treatment. She lived alone and was not currently working. She injected heroin daily and smoked crack cocaine several times per week. She smoked 20 cigarettes per day and did not drink alcohol.
