45 year old hair dresser

PC: headache

HPC: gradual onset during last 3 days

yesterday N&V x3 (nausea and vomiting)

mild photophobia for 1 day, but now has difficulties focussing + double vision

pain mainly left parietal and frontal

similar episode 16 years ago while travelling to Scotland

no neck stiffness, no fever, no rash

PMH: occasionally migraine (usually quite mild)

? IgA deficiency – never caused problems

renal impairment due to right kidney stone

childhood eczema – now settled

mitral valve prolapse

DHx: paracetamol and ibuprofen for 3 days

occasionally sumatriptan for migraine

OTC (over the counter) vitamins and iron

FHx: daughter: infectious mononucleosis recently, had thymoma aged 3

father: myasthenia gravis

twin sister: acoustic nerve neuroma

SHx: lives with husband, 2 daughters and 3 parrots

smokes 7 cigarettes per day, occasionally alcohol

recently changed jobs to different employer