A 17-year-old girl is admitted to the emergency department complaining of nausea and severe vertigo. This has developed over the past few hours, and previously she was well. She has the sensation of her surroundings spinning around her. She feels nauseated and sleepy. She does not have a headache. She has not had any previous medical illnesses. She is a non-smoker and says that she does not drink alcohol or take recreational drugs, and she is taking no regular medication.
She lives with her parents and is due to sit her A-levels in 3 weeks. Her father suffers from epilepsy, and her mother has hypothyroidism. Examination She is drowsy, and her speech is slurred. Her pulse rate is 64/min, blood pressure is 90/70 mmHg, and respiratory rate is 12/min. Examination of her cardiovascular, respiratory and abdominal systems is otherwise normal. Her peripheral nervous system examination is normal…
