Keywords: takayasu arteritis • epileptic seizure • bruitBackground: Takayasu arteritis is a vasculitic disease involving major arteries. It commonly presented with constitutional symptoms. Neurological manifestations such as headache, transient ischemic attack, stroke, vertigo, dementia, confusion, hypertensive encephalopathy and bilateral blindness can be the presenting features rarely. Takayasu arteritis presenting as epileptic seizure is extremely rare. We report a 32 years old previously healthy lady presented with a history of generalized tonic clonic seizure associated with loss of consciousness and ultimately found to have takayasu arteritis and manage with steroids successfully without antiepileptic drugs.

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Picture quiz 46 2. A 40-year-old woman was admitted with right upper quadrant pain for two weeks. Pain was accompanied by vomiting and fever. Laboratory investigations demonstrated elevated serum alkaline phosphatase (ALP) with normal serum bilirubin. Ultrasonography of the abdomen showed slightly dilated common bile duct. She underwent Endoscopic Retrograde Cholangio Pancreatography (ERCP). Below is the ERCP image.What is the diagnosis? Picture quiz -GastroenterologyThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.