Bilateral Ischaemic Stroke in Eosinophilic Granulomatosis With Polyangiitis

A woman in her seventies with a recent diagnosis of asthma presented with right-sided limb weakness and progressive neurological decline. Magnetic resonance imaging of the brain revealed bilateral ischaemic infarcts in watershed territories. Further clinical deterioration prompted extensive investigations, which demonstrated multisystem involvement, including the lungs, heart, kidneys, and skin. A diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) was made. The patient was started on immunosuppressive therapy and antiplatelet agents, leading to significant clinical improvement. Although central nervous system involvement can occur in EGPA, ischaemic stroke remains a rare manifestation. This case highlights the importance of considering systemic vasculitis in patients presenting with stroke and multisystem features.