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A 78-year-old man presented with acute altered mental status, with a Glasgow Coma Scale score of 14 (E4 V4 M6). His bilateral pupils were dilated with a sluggish pupillary response to light. His serum glucose, electrolytes and ammonium levels were normal, but his QTc (0.51 ms) was prolonged. Fluid-attenuated recovery MRI showed small high-signal intensity lesions in the right insula (figure 1A) and bilateral temporal lobes (figure 1B) of the brain. All symptoms subsided within the day of …
Contributors Both authors looked after the patient, wrote the draft and approved the submission of the manuscript. AK serves as a guarantor for this article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.
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