Clinical reasoning: encephalopathy in a 10-year-old boy.

Lance Rodan, MD Ingrid Tein, MD, FRCPC SECTION 1 A 10-year-old, right-handed boy with a several-day history of fever and upper respiratory symptoms presented with acute onset headache, emesis, progressive mental status change, and right-sided focal seizures. Symptoms developed over approximately 3 hours. There was no history of recent toxic or medication exposures, travel, immunizations, sick contacts, insect bites, or animal exposures. The general review of systems was negative.