![]() ![]() Full blood count, Erythrocyte Sedimentation Rate, C-reactive protein level, fasting blood sugar, serum urea and creatinin levels, liver function test, serum levels of sodium, potassium, calcium and magnesium, HIV and syphilis serologies were all normal. Urine analysis showed a high level of Δ-9-tétrahydroxycannabinol (Δ-9-THC), superior to 150 ng/ml. The cardiac examination revealed a regular tachycardia without murmurs. We found a bilateral and asymmetric hyperreflexia predominant on the left body side, bilateral Babinski sign, but the muscle strength was normal. Neurologic examination revealed an arouse patient, with psychomotor slowing. On admission, one day after the last seizure, his general state was good, vital signs revealed a blood pressure of 110/80 mmHg, a pulse rate of 104 beats per minute, a respiration rate of 18 breaths per minute, a temperature of 37.2☌, a weight of 56 kg and a height of 1.62 m. There was no notion of alcohol intake, or head trauma before the onset of symptoms. He had a history of regular marijuana smoking for 26 years, but no history of recurrent headache or seizures in childhood and in his family. However, he did not have any seizure until this consultation. He consulted at a Health Dispensary where he was prescribed, without any brain imaging phenobarbital: 100 mg/day and paracetamol for pain, but his compliance to treatment was poor. He presented 08 months before this admission a severe headache of abrupt onset during a period of heavy smoking of marijuana, associated with one generalized tonic-clonic seizure. The patient was a 44-year-old man, single and jobless who was admitted in the neurology department for three isolated episodes in five hours, of secondary generalized left body side tonic-clonic seizures lasting less than ten minutes each.
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