Approach to a first unprovoked seizure (pediatrics) Quiz: Ace Your Exams

A 13-month-old infant boy is brought by his parents to the emergency department for evaluation following an episode of convulsions. His parent was putting the patient to bed when he suddenly opened his eyes, arched his back, and had stiffening of all four extremities, followed by rhythmic jerking lasting for 20 seconds. He subsequently went limp and began crying softly. He was diagnosed with left acute otitis media yesterday and was started on oral amoxicillin. He otherwise has no significant medical history and does not take daily medication. He has not been left unsupervised. Temperature is 37.5°C (99.5°F), pulse is 128/min, respirations are 30/min, and blood pressure is 80/45 mmHg. On exam, the patient is sleeping but arousable to touch. Mucous membranes are moist. There is no meningismus or rash. He moves all extremities spontaneously. His left tympanic membrane is erythematous. Which of the following additional historical factors is most likely to be found?