A previously healthy 3-year-old boy presented to a pediatric emergency department with reported altered mental status. According to reports from his family, he awoke 3 hours prior to arrival and was complaining that his head hurt. Over the next hour, his behavior changed, becoming progressively less interactive with family. Most notably, he was reported to be wandering around the house appearing confused. His family initially took the patient to an urgent-care facility.
Once in urgent care, he was noted to be lethargic with rightward deviation of both eyes. The patient was immediately transferred to the pediatric ED via emergency medical services. The patient's mother denied any trauma, toxic ingestions, fevers, chills, rashes, recent illnesses, or respiratory, cardiac, genitourinary, or gastrointestinal complaints. The patient had no significant past medical, surgical, or family…
