Parkinson, MH; Patel, R; Davagnanam, I; Wood, NW; Giunti, P; (2014) When the penny drops. Pract Neurol , 14 (6) 409 - 414. 10.1136/practneurol-2014-000859.

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Abstract

A 26-year-old woman presented after developing slurred speech and drooling overnight. She had a 6-month history of tiredness and poor concentration, and episodes of loss of consciousness accompanied by paraesthesia of her hands, feet and mouth. Occasionally, one arm would ‘hang in a strange way’. Her mother reported a preceding personality change with angry outbursts and anxiety, although these had largely subsided after starting antidepressants. Her only past history was a severe depressive episode in her teens and a difficult and occasionally abusive family life. There was no family history of neurological disease. On examination, she was alert and orientated. There was mild dysarthria but normal motor, sensory and coordination examination.

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