Description
A 16 year old girl was referred to the paediatric
endocrine clinic because her thyroid function tests
showed a low serum free thyroxine (FT4
) of 7.4
pmol/L (Reference interval 12.0-22.0 pmol/L) in
the presence of a normal serum Thyroid
Stimulating Hormone (TSH) 1.17 mU/L
(Reference interval 0.27-4.2 mU/L). She had
temporal lobe epilepsy, severe learning difficulties
and behavioural problems with a history of selfmutilation. Her epilepsy was diagnosed at the age of
21
/2 years at which time metabolic investigations, a
screen for infection and electroencephalogram were
normal as was a subsequent computerised
tomography scan of her brain. Her epilepsy was
now well controlled by a combination of
gabapentin, carbemazepine, and acetazolamide
