A sleepless young man with red eyes and slurred speech?

摘要

A 37-year-old Indian gentleman presented to the emergency department with sudden-onset slurred speech associated with recent sleep disturbances and a 2-year history of recurrent sinusitis, nosebleeds and intermittent redness of his eyes. There was no associated headache, word finding difficulties, focal weakness, visual deficits or cognitive impairment. There was no haemoptysis, shortness of breath and no previous history or risk factors for cardiovascular disease.