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In January, 2016, a 15-year-old girl with a history only of an ovarian cyst was admitted to hospital in Pointe-?-Pitre, Guadeloupe, with left hemiparesis. 7 days previously she had presented to the emergency department with left arm pain, frontal headaches, and conjunctival hyperaemia, but no fever, signs of meningeal irritation, or sensory or motor deficits. The day of admission, she developed acute lower back pain, paraesthesia on the left side of her body, and weakness in her left arm. On admission she had slight left-sided weakness and proximal pain of the left arm and leg, exacerbated on movement, but no fever or signs of meningism, and Glasgow Coma Score (GCS) 15. Laboratory analyses were normal except for raised leucocytes (11?5 ? 10[SUP]9[/SUP]/L) and polymorphonuclear leucocytes (9?2 ? 10[SUP]9[/SUP]/L). Brain MRI was normal.
