Mackenzie is a 49-year-old woman who was admitted to the emergency department (ED) with status epilepticus. She has a history of traumatic brain injury (TBI), which was treated surgically with a right hemicraniectomy and a subsequent anterior temporal lobectomy. Her neurological status on admission was described as poor. She has limited functional ability at baseline due to residual paralysis on the right side of her body and limited movement on the left, but she can respond nonverbally to yes-no questions. In the ED, Mackenzie was briefly supported with mechanical ventilation while she was medically treated for her seizures. The results of a noncontrast computed tomography scan of her head and laboratory values were negative. Mackenzie’s clinicians suspected a urinary tract infection and treated her accordingly with antibiotic therapy. Her postictal state following extubation was characterized by alternating periods of lethargy, poor tracking to voice, and moaning to verbal and physical...

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