Is the first seizure truly epileptic?

Transient loss of consciousness (T-LOC) with abnormal posture or movements reflects a temporary dysfunction of the brain, either primary or secondary. In a period of high technological medical access, patients with T-LOC constitute a challenge to improve the medical "art of listening." The difficulty in dealing with isolated paroxysmal phenomena is associated with the probability of the occurrence of a second event and therefore the entrance of the patient into a chronic disorder. We present a detailed analysis of symptoms that should help the general practitioner in the differential diagnosis among three main entities in the adult populations: syncope, epileptic seizure, and psychogenic seizure (dissociative convulsion).