Case History: 48-year-old man with a diagnosis of HIV infection since 1993, on HAART (abacavir, lopinavir-ritonavir, and stavudine) with a recent CD4 count of 692, and undetectable viral load for years type II diabetes, and generalized tonic-clonic, complex partial and motor seizures since childhood. His seizures had been well controlled on phenobarbital, levetiracetam, and zonisamide for many years. Prior Electroencephalograms (EEGs) had evidenced right temporal discharges without clinical seizure activity. His brain magnetic resonance imaging had remained normal. He resides at a group home, where he was responsible for taking his medications.
Current SItuation: The patient presented with repeated admissions due to changes in mental status. He consistently became somnolent, arousable to voice, and able to follow simple commands. He had symmetrical fine and course nystagmus. His tone…
