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Misleading rash after an unwitnessed epileptic seizure
  1. Sandra Huijs1,
  2. Myriam Franssen2,
  3. Esther Yeung1,
  4. Daphne Wijsmans3,4
  1. 1 Neurology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  2. 2 Emergency Medicine, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  3. 3 Dermatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  4. 4 Dermatology, KU Leuven University Hospitals Leuven Gasthuisberg Campus Hospital Pharmacy, Leuven, Belgium
  1. Correspondence to Sandra Huijs, Neurology, Zuyderland Medical Centre Heerlen, Heerlen, Netherlands; sa.huijs{at}

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A 19-year-old man with coeliac disease presented to the emergency department with an altered mental status and a rash over the last hour. He had worked all day and had eaten with his parents after work. Afterwards he went to bed feeling exhausted. At 20:30, he came downstairs and was confused, incontinent of urine and felt warm. There was a rash around his left eye. In the emergency department at 21:30, he had a fever of 38.8°C and a headache, and he vomited once. His airway and breathing were normal, and there was no tongue bite. He had a tachycardia but was normotensive. There was no meningism, but he was disorientated in time and there was right arm weakness. He had a rash around the left …

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  • Contributors SH undertook the drafting of the article. SH and MF contributed to the patient’s initial clinical assessment. MF, EY and DW critically reviewed the manuscript and provided feedback.

  • 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.

  • Provenance and peer review Provenance and peer review. Not commissioned. Externally peer reviewed by Rhys Thomas, Newcastle-upon-Tyne, UK.