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A 15-year-old girl, previously healthy with normal developmental history, had an episode of unilateral arm jerking at school followed by transient loss of consciousness. Two weeks later, she presented to the emergency department with recurrent generalized convulsions despite treatment with lorazepam and fosphenytoin. In retrospect, her family reported a 1-month history of personality changes (i.e., listlessness) and decline in academic performance. There was no family history of epilepsy, metabolic disorders, or immunodeficiency. The patient resided in rural northeastern Kentucky. There was no recent travel history.
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Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- Received December 19, 2016.
- Accepted April 17, 2017.
- © 2017 American Academy of Neurology
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