'Looks like epilepsy to me!'

Abstract

‘Looks like epilepsy to me!’ The late Professor Bryan Matthews did not get much wrong, but in the early 1980s he and I did not know about ‘limb shaking’ transient ischaemic attacks when I asked him to have a look at a patient under my care at the Radcliffe Infirmary in Oxford. Indeed, it was only in the 1980s that good descriptions were emerging of this unusual type of transient ischaemic attack, mostly in the US literature, and the fact that it almost only ever occurred in patients with very severe carotid disease in their neck—bilateral occlusion or severe stenosis, or unilateral occlusion with contralateral severe stenosis. What put me off focal epilepsy was that this patient also had severe bilateral carotid disease, a fact that I had not revealed to Professor Matthews, to avoid …