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What is the most likely diagnosis for this patient? Why?

What is the most likely diagnosis for this patient? Why?

K.G. is a 5 year old kindergarten student that is brought to the ER by his mother after she witnessed apparent seizure activity. His mother describes it as jerking of both arms and legs, and that he wouldn’t answer when she called his name. She doesn’t remember much else, thinks it might have lasted a few minutes, but she is not sure “it seemed like forever”. She doesn’t know any family history, K.G. is adopted and health records were not provided. He has never had an episode like this before. Upon examination K.G. appears lethargic, makes eye contact when his name is called, but quickly drifts back to sleep. Vital Signs are unremarkable, shorts are damp and there is a urine smell. K.G.’s right arm is in a cast and there is ecchymosis on his right chest and abdomen. Upon questioning his mother reports he fell off the jungle gym at school last week.

What is the most likely diagnosis for this patient? Why?

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