My 30 year old brother has Autism, Aspergers, ADHD, mild depression, a history of seizures and a heart murmur. All of which have been managed for the past 12-20 years with various common prescribed medications. The medications he is currently taking have been the same dose for at least the past 10 years. A week ago, he started complaining of joint pain, fatigue, loss of appetite, headaches, and in general he stated He didn t feel himself. . My mother and I attributed his symptoms to that of heat exhaustion due to his occupation (warehouse work/no air conditioning/Texas heat). This day in particular, we brought him home, cooled him down, made sure he had plenty of fluids, and his symptoms seemed to subside. A few days passed and he still didn t seem himself but he wasn t complaining about anything in particular. Yesterday, he phoned my mom while at work complaining of the same symptoms. Again, my mother picked him up from work however this is when things began to escalate. She was driving him home and attempting to figure out what exactly was wrong with him, as she asked simple questions like Where is the pain? Or How is it you feel bad? What feels bad? He proceeded to answer with incoherent responses and jibberish. At this time she says he recognized her but wasn t making an sense at all. Worried, she started driving him to a local urgent care clinic. Along the way he began falling in and out of sleep. When arriving at the clinic, upon getting out of the car he proceeded to vomit. While attempting to get him inside and onto a gurney, he then went into a full Grand Mal seizure...something he hasn t had In over 8 years. He was then rushed to the local ER where he was given heavy doses of anti seizure medication that did absolutely nothing to stop the seizure. He seized for approximately 8-10 minutes! When convulsions stopped, he proceeded to be combative and violent towards everyone including my mother, which at this point he did not recognize. Eight hours passed and toxicology reports indicated nothing wrong, no critically low levels, no overdose. Emergency sedation was required due to his combative state. Each time he wakes up he doesn t recognize anyone and he is trying to fight back, as if he hasn t completed the seizure and is fight or flight mode. He does not respond to verbal commands and is seemingly disconnected from the world. It has now been almost 24 hours and his mental status has not improved. Still violent, still doesn t recognize his family, or connect that he is awake. His vitals are normal and he has not had another seizure. He was seen by a neurologist and the only other possibility he thinks could be related to tick or mosquito bites? My question is, based off your experience, expertise, medical knowledge, and the info I ve provided.... is there a high probability this is how he will be forever? Does he have permanent brain damage and will he be combative forever? Will this result in a medically induced coma resulting in a decision needing to be made about his life or death?