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Signs of a Seizure and Differential Diagnosis

Signs of a seizure:

  • Loss of consciousness or arrest of behavior

  • Abnormal eye movements: rolling up or deviated to one side

  • Abnormal movements of the limbs: stiffening, rhythmic jerking, loss of tone

  • Loss of bowel or bladder control

  • Drooling, teeth clenching, tongue biting

  • Abnormal respirations: temporary pause, grunting 


Differential diagnosis for seizure:

  • Syncope, convulsive syncope

  • Complicated migraine or migraine with aura

  • Gastrointestinal disorders (reflux)

  • Psychiatric conditions (panic attacks, psychogenic non-epileptic events)

  • Transient ischemic attack

  • Movement disorders

  • Breath holding spells

  • Sleep disorders (night terrors, cataplexy)

  • Stereotopies (hand flapping)

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.