A 75 year old man presented with a four week history of an acute confusional state, marked weight loss, and deteriorating mobility. After admission he suffered a grand mal seizure. He was known to have longstanding essential hypertension controlled with atenolol and chlorthalidone. He had smoked 15 cigarettes a day for almost 40 years. He had previously worked as an electrician and had occasionally been in contact with asbestos sheets
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