As an internist who teaches first and second year medical students the importance of history taking in making a final diagnosis, I have to put in my "two-cents" and that is for a patient who uses the word "seizure" which is a commonly used word to explain exactly what is meant by "seizure". That is, what are the symptoms and what had actually occurred which caused the patient to call the event as a "seizure". With this information, much of the diagnostic possibilities, many of which have been described above can be eliminated. The use of the general term "seizure" is much like a patient using the word "dizzy" which itself could represent disorders in the categories of vertigo, pre-syncope, disequilibrium and other "head" conditions including psychologic. The word "constipation" is another common word used by patients which requires further detailing to understand whether this a true pathologic symptom or something within a normal range for a particular individual.

What I am trying to get at here is, in practice, not to jump to the assumption that the word "seizure" represents some pathology and needs to cause the physician to quickly develop a whole panoply of diagnoses or causes. What is most important is what the word "seizure" means to the patient. Who knows, maybe what the patient means by the word "seizure" is a normal physiologic response such as being "startled" by a noise or a visual surprise and no differential diagnosis for pathologic conditions is really necessary. ..Maurice..