Review Question - QID 213617

A 1-year-old girl presents to the emergency department with a change in her behavior. Prior to presentation, the patient’s parents state that the patient became unresponsive and demonstrated jerking motions which stopped after 1 minute. They state their daughter is up to date on her vaccinations and has been healthy except for a recent cold. Her temperature is 105.0°F (40.6°C), blood pressure is 80/48 mmHg, pulse is 180/min, respirations are 25/min, and oxygen saturation is 99% on room air. Physical exam is notable for a fatigued appearing child. During the exam, the patient has another episode of decreased responsiveness with jerking of her extremities. The episode resolves on its own within 30 seconds. The patient is given IV fluids and acetaminophen and is ultimately discharged. The patient returns to the emergency department after this visit with the physical exam finding in Figure A. Her vitals upon presentation are unremarkable. Which of the following is the most likely diagnosis?