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Ilse C A Bakker, Chris D Schubart, and Pierre M J Zelissen

rhinorrhoea after medical treatment with dopamine agonists for macroprolactinoma has been reported ( 2 ). Psychiatric adverse effects may also occur and include insomnia, nightmares, hallucinations and even psychosis ( 3 ). The treatment of a patient with

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R D’Arcy, M McDonnell, K Spence, and C H Courtney

, insomnia and a degree of weight loss. There was no clear precipitant to the symptoms reported and no suggestion of recent infection. On clinical examination he appeared tremulous and diaphoretic. There was a regular tachycardia of 110 bpm, and mild

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Elizabeth M Madill, Shamil D Cooray, and Leon A Bach

presence of parathyroid tissue with uniformly round typical nuclei and no areas of necrosis or fibrous septae. On post-operative day 1, the patient developed irritability, palpitations, insomnia and vivid dreams. Physical examination revealed signs of

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Guadalupe Vargas, Lourdes-Josefina Balcazar-Hernandez, Virgilio Melgar, Roser-Montserrat Magriña-Mercado, Baldomero Gonzalez, Javier Baquera, and Moisés Mercado

associated with nausea, vomiting or visual abnormalities. She also complained of anxiety, insomnia and occasional palpitations for about 6 months, but specifically denied acral changes and galactorrhea. She did not smoke or abuse alcohol or recreational drugs

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Hui Yi Ng, Divya Namboodiri, Diana Learoyd, Andrew Davidson, Bernard Champion, and Veronica Preda

patient management ( 3 ). Case presentation A 51-year-old builder presented with an 8-month history of headaches, dizziness, anxiety, palpitations, hypertension, insomnia and heat intolerance. There was no history of visual disturbance nor symptoms

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Tzy Harn Chua and Wann Jia Loh

. Case presentation A 50-year-old male presented to the emergency department with 2-day history of insomnia, severe nausea and dizziness. This was associated with a generalised dull headache. He denied any other neurological symptoms and weight loss. A

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Durgesh Prasad Chaudhary, Tshristi Rijal, Kunal Kishor Jha, and Harpreet Saluja

-year-old dwarf female presented with complaints of delusion of reference, delusion of persecution, thought broadcasting and insomnia. One week before coming to the OPD, she called the emergency services and explained to police that her neighbors were

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Mohammed Al-Sofiani, Dhimitri Nikolla, and V V S Ramesh Metta

was associated with significant orthopnea causing insomnia the night before her ED presentation. She also noticed swelling of both lower limbs and hands. Review of systems was remarkable for lethargy, cold intolerance, constipation, menorrhagia for 5

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Mike Lin, Venessa Tsang, Janice Brewer, Roderick Clifton-Bligh, and Matti L Gild

, without hot flushes, insomnia or mood instability. There were no symptoms of diabetes insipidus or galactorrhoea. The patient recalled presenting to the emergency department 18 months earlier with similar symptoms. Non-contrast CT of the brain was

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Serena Khoo, Greta Lyons, Andrew Solomon, Susan Oddy, David Halsall, Krishna Chatterjee, and Carla Moran

asymmetric proptosis ( Fig. 2A ), together with thyrotoxic symptoms (restlessness, insomnia and muscle weakness), suggestive of Graves’ disease (GD) with Graves’ ophthalmopathy (GO). On 125 µg thyroxine replacement, elevated FT4 (62.7 pmol/L), suppressed TSH