MEDizzy - A 3-yr-old boy is being evaluated after an episode at home

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CNS

A 3-yr-old boy is being evaluated after an episode at home during which he lost consciousness for 5 min; he was brought to the emergency department an hour later. On examination, which of the following factors is most helpful in distinguishing whether this episode was a seizure or syncope?

ExplanationSyncope usually produces a loss of tone and a fall, with rapid recovery of consciousness once the affected person is in a horizontal position. Occasionally there may be a few tonic-clonic jerking movements with syncope, thus confusing the assessment.