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The resources of accident and emergency (A&E) departments are often required to treat patients who are not within the catchment population of the local health authority. An assessment of workload caused by this particular group was carried out over a 2-month period at Northampton General Hospital which serves a population of 318,000. Details were collected and analysed on the patients' reason for attendance, investigations and treatment.

The case of a 32 year old female who presented with her first epileptic fit and took over 36 hours to recover is described. Investigations led to a diagnosis of hypothyroidism as the cause. Following treatment with thyroxine she has remained well with no further fits for over 2 years. Hypothyroidism should be considered as a possible underlying cause of epilepsy especially when there is a prolonged recovery time after a fit.

The case of a woman presenting with acute urinary retention, which, on investigation, proved to be due to the ovarian remnant syndrome, is reported. This syndrome is rare, with only 36 previously published cases. To our knowledge none has so far presented in this manner.