A 41-year-old man with quadriparesis who had been bedbound for 12 years following a road traffic crash and had multiple decubitus ulcers presented to our emergency department with complaints of 2 days of slurring of speech and facial deviation with 1 seizure episode. He had a history of type 2 diabetes. On physical examination, he was conscious and oriented, had slurring of speech, was able to obey simple commands, and had no meningeal signs. His pulse rate was 101 beats per minute, and his blood pressure was 120/80 mm Hg.