Postictal state [top]

  • History of preceding seizure
  • Todd's paralysis: Motor weakness, amnesia, aphasia
  • May be associated drowsiness, confusion, nausea

Febrile convulsion [top]

  • Generalized seizure in child associated with elevated body temperature fever

Brain tumour [top]

  • Gradual onset of headache chronic headache seizure
  • Neurological deficit
  • Signs of raised intracranial pressure, papilloedema

Meningitis [top]

  • Acute headache
  • Photophobia, neck stiffness, meningism, Kernig's sign positive
  • Fever, vomiting, seizure
  • Non-blanching purpuric rash with bacterial meningitis

Hypoglycaemia [top]

  • Syncope, transient neurological deficit
  • Preceded by sweating, hunger
  • History of diabetes / insulin
  • Preceded by hunger, sweating, disorientation
  • Usually known diabetic
  • Excessive insulin or insufficient food

Epilepsy [top]

  • Tonic-clonic seizure, syncope
  • Previous history of seizures if known epilepsy
  • Prolonged 'post-ictal' recovery period
  • Incontinence of faeces / urine urinary incontinence faecal incontinence

Pseudoseizures [top]

  • Often bizarre movements, however can be difficult to distinguish from epilepticseizures
  • Distinguishing features: biting tip of the tongue, duration > 2 minutes, closed eyes, side to side head movements

Electrolyte disturbance-induced seizure [top]

  • Seizure
  • Severe hyponatraemia, hypernatraemia, hypocalcaemia, hypomagnesaemia

Circulatory shock [top]

  • Sudden loss of cardiac output
  • Loss of consciousness, seizure

Alcohol withdrawal [top]

  • History of excessive alcohol consumption