A 44-year-old right-handed female driver developed a new onset moderately severe headache with vomiting. She attended hospital and had a CT scan of her brain and a lumbar puncture performed; both were reported as normal. She was discharged from hospital but over the next week the headaches became more severe and vomiting recurred. Then, 11 days after the onset of headache, she developed slurred speech and impaired concentration. She giggled inappropriately and became confused. Her condition fluctuated but did not return to normal. She had no oral or genital ulcers but had noticed decreased hearing on her right side. She was re-admitted to hospital and a neurological opinion was sought.