This case presents a 19-year-old Hispanic woman with a history of bipolar I disorder and conduct disorder diagnosed at age 13, with 6 previous psychiatric inpatient hospitalizations. The patient presented to the emergency room with agitation, irritability, and flat affect that began 3 hours after a new-onset seizure episode. The patient was discharged home; however, 2 days later, she experienced her second seizure, along with disorganized behavior, walking barefoot down the street, as well as visual hallucinations and selective mutism. The patient returned to the emergency room and was admitted to an inpatient psychiatric unit. An EEG exam was unremarkable; however, on the basis of clinical presentation, she was diagnosed with Generalized Seizure Disorder, Tonic-Clonic Type. She was treated with the antiepileptic levetiracetam and was given risperidone for psychotic symptoms, as well as valproic acid, which improved her assaultive behavior. Upon discharge, she continued to have residual negative symptoms, which could suggest the diagnosis of schizophrenia. However, because of the time-course of symptomatology and considering the link between seizure disorder and psychosis, we propose that the patient meets DSM-IV-TR criteria for the diagnosis of Psychotic Disorder Due to Seizure Disorder With Hallucinations.