Unexplained nausea

What is causing Gill’s chronic vomiting and why does taking hot baths help?

A 36-year-old woman, Gill, presents to the ED complaining of muscle pains, persistent vomiting, abdominal pain and pins and needles in her hands and feet.


She has difficulty walking, complains of chills and sweats, and is feeling globally weak. 

Gill has been previously well, she is not taking any medications and has no family history of muscle diseases. She is a social drinker and smoker. 

During the past few days she has noticed decreased urine output and dark urine. 

This is Gill’s third admission with hyperemesis and dehydration of