A 54-year-old man who was previously found to be COVID-19 positive received two doses of mRNA-1273 (Moderna) vaccine 4 weeks apart, as recommended by the manufacturer. He was brought to the emergency department 1 day after second dose of the vaccine with altered mental status, headache and high fever. The patient was hospitalised for 2 days and managed with supportive care. He completely recovered with return of mental status to baseline and resolution of fever.

Psychogenic nonepileptic seizures (PNES), historically referred to as pseudoseizures or hysterical seizures, are sudden disturbances of motor, sensory, autonomic, cognitive, or emotional functions that can mimic epileptic seizures. PNES have a psychologic etiology related to dissociative disorders or conversion disorders, as opposed to the abnormally excessive neuronal activity found in epileptic seizures. Psychosocial conflicts are essentially converted into physical symptoms, resulting in seizure-like symptoms. This case report presents a 42-year-old male with a past history of child abuse, drug abuse, schizoaffective disorder, prior psychiatric hospitalizations, and diabetes mellitus type 2 who was admitted to the behavioral health unit with recurrent seizure-like episodes. These episodes were witnessed in the ED, however, appropriate workup failed to confirm abnormal neural activity or evidence of any brain injury. The patient was admitted to the psychiatric service where he was monitored for additional epileptic activity using long-term video-electroencephalogram (EEG) monitoring (LT-VEEG). While subsequent clinical events that resembled epileptic seizures were observed, the LT-VEEG failed to identify any epileptic activity. A diagnosis of PNES was established and a decision was made for the patient to remain on his current antiepileptic, psychiatric, and diabetes medications during his hospitalization. He showed gradual improvement during his stay and confirmed an understanding of his diagnosis. He was released three days later with instructions for follow-up and continued treatment with his outpatient psychiatrist. Early therapeutic counseling in patients who have a differential diagnosis of PNES should be considered to help identify and address the underlying causes of the seizure activity in an effort to curtail these seizure-like events.

Alcohol-induced psychotic disorder is a rare complication of chronic alcohol abuse following abrupt alcohol cessation that is characterized by visual, auditory, or tactile hallucinations paired with intact orientation and stable vital signs, distinguishing the condition from delirium tremens and psychotic disorders. The condition, first termed alcoholic hallucinosis, has been described in medical literature for over a century, however, its nosologic classification and psychopathologic characteristics are less well-documented. One such case of alcohol-induced psychotic disorder with multimodal hallucinations of four months duration is described here.

We report one of the unusual presentations of disseminated gonococcal infection. This case report describes a 24-year-old woman who presented with disseminated gonococcal infection manifesting as meningitis. Cerebrospinal fluid (CSF) and throat swab PCR were positive for Neisseria gonorrhoeae. Blood and CSF cultures were negative for bacterial growth. The patient was treated with a total of 14 days of intravenous ceftriaxone. She was discharged with no neurological sequelae.