Neil Ramsay*, Esther Sammler, Wail Ahmed and Avinash Kanodia
History and Background: A previously fit and well 16 year old school girl presented to the medical admissions unit with an acute onset of strange behaviour and reduced speech output over the previous few days. Collateral history from her mother revealed gradually worsening headaches over the previous 2 weeks. The headaches were worse on lying down and in the morning. Past medical history was unremarkable. She was on no regular medication and illicit substance use was denied.