Case of the Week: Transient Neurological Symptoms

A 32 year old female presents with an expressive dysphasia to her GP. Her GP initially thinks it could be migraine as she recalls a mild headache. However, he explains to the patient that she needs to be seen in the hospital for a check up.

She has no visual symptoms, motor symptoms or other neurological symptoms or signs.

By the time she arrives in the Emergency department, her symptoms have entirely resolved.

O/E

Temp 36 o Celsius

BP 112/78

Sats 99% Air

GCS 15/15

Fingerprick Blood glucose 3.9mmol/l

On examination she has an entirely normal neurological examination. The rest of the general examination is unremarkable other than a soft systolic murmur.

Is there anything else to be done, or should she simply see her GP for a follow up and consideration of a referral to a headache clinic? If there is something to be done, what is it and why?

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