Mass Confusion

Abstract

A previously healthy 18-year-old male university student presented to the emergency department with first presentation of generalized tonic-clonic seizure. History of present illnessThe present illness was preceded by a diffuse headache, which worsened over 3 days and was partially relieved with acetaminophen. The headache was accompanied by chills but no fever. The patient described the headache as intense pressure over the top of his head. There were no associated vision or hearing changes, focal neurologic symptoms, confusion, or vertigo. One week prior to presentation in the emergency department, he underwent wisdom tooth extraction with no complications. The generalized tonic-clonic seizure was witnessed by his father and lasted approximately 5 minutes, which prompted his visit to the hospital. After the seizure, he had roughly 20 minutes of selfresolving confusion. The patient was well up until this event and receiving no medications.