Anorexia nervosa is an intense fear of weight gain, inaccurate perception of body size, weight or shape, amenorrhoea, and a body weight <85% of expected weight (or body mass index (BMI) ⩽17.5). We report a patient who, following a left thalamic stroke demonstrated a remarkable recovery from a 7 year history of anorexia nervosa.

The patient grew up in a family with both parents and two older brothers. When she was 14 years old, a young cousin died of a “brain haemorrhage”. Six months later the patient started a “healthy eating” regimen. She was first admitted to hospital for her eating disorder in April 1995, aged 15 years, and was prescribed antidepressant medication. The problem continued despite psychiatric and psychological treatment (usual weight 43 kg, BMI 17).

In May 2002, aged 22 years, she experienced a sudden onset of right arm and leg weakness with a sensory disturbance of the right face, arm, and leg. There was no history of diabetes, cigarette smoking, illicit drugs, or oral contraceptive use. She was admitted to hospital. She was told that a computerised tomogram (CT) showed that she either had a brain tumour or had suffered a stroke. She was transferred to the regional neurology unit. There she was alert, but had a slight decrease in sensation …