Clinical Reasoning: A 22-year-old postpartum woman with new-onset seizures and headache.

A 22-year-old right-handed woman with no relevant medical history presented 7 days after delivery of her first child with new-onset seizures. Her pregnancy was unremarkable and she received standard prenatal care. During spontaneous vaginal delivery of her healthy full-term baby, she developed fever (39.6°), tachycardia, and cough. Influenza B antigen was detected on nasopharyngeal swab consistent with respiratory influenza and she was started on a 5-day course of oseltamivir. She was discharged home after 2 days and her respiratory symptoms resolved. On postpartum day 7, she had 2 generalized convulsions lasting 1–2 minutes each. Her family noticed right elbow flexion and head version to the left at onset, but did not recall any movements of her left upper extremity. Afterwards she was confused and somnolent for several hours and did not recall either event. Review of systems was notable for a new-onset headache which was moderate intensity, bifrontal, nonpositional, with a pressure/throbbing quality starting 1 day prior to presentation. Family history was unremarkable. She had normal development, completed high school, and worked full-time as a cashier.