Altan is a 45 year old man brought into ER by his family with a history of generalized tonic-clonic seizure lasting 15 minutes at home.  He has no previous history of seizures, but is known to be a regular heavy drinker.

On examination he is drowsy, localizing pain but not speaking clearly. His eyes are open. BP 130/80, pulse 100bpm, Respiratory rate 20.  Cardiovascular and respiratory system are normal. He is apyrexial, moving all four limbs with normal reflexes. Pupils are reactive.