Snapshot A 79-year-old man presents to the emergency department after a fall complicated by a head strike. He underwent a non-contrast CT head, which demonstrate bilateral subdural hematoma without evidence of cerebral herniation. Neurosurgery was consulted and determined the intracranial bleeds were small and his neurological exam was unremarkable. He was also found to have a complicated urinary tract infection, requiring hospital admission for treatment with intravenous antibiotics. On hospital day 3, the patient has a generalized tonic-clonic seizure that lasted 6 minutes. He is started on intravenous lorazepam and is loaded with levetiracetam. His seizures eventually clinically abort and he is placed on electroencephalography. Introduction Definition login to view 2 more bullets Etiology Structural abnormalities login to view 5 more bullets Infections login to view 2 more bullets Metabolic abnormalities login to view 6 more bullets Medications/toxins login to view 6 more bullets Pathogenesis Uncontrolled neuronal excitation and reduced neuronal inhibition Presentation Symptoms/physical exam login to view 2 more bullets Imaging CT head without contrast login to view 2 more bullets MRI brain login to view 3 more bullets Studies Electroencephalogram login to view 3 more bullets Serum studies login to view 3 more bullets Treatment Medical login to view 14 more bullets Complications Cardiac arrhythmias Hypoxia Aspiration pneumonitis and respiratory failure