ABSTRACT
Children often present to the doctor having had an unexplained episode of collapse, reduced level of consciousness, or abnormal movement or behaviour. The most important part of the assessment is a history from an eye witness. Important signs to enquire about include colour, particularly of lips and tongue, incontinence in older children, type of abnormal movements (ask the witness to demonstrate if possible) length of episode, precipitating factors, and postictal symptoms. Ask about family history, neonatal history and past medical history. Does the child have behavioural or learning problems? It is extremely important to diagnose epilepsy correctly to prevent unnecessary restriction on the child and to obtain appropriate treatment. Babies may present with unexplained apnoea with or without abnormal movement and the differential diagnosis is very different from that in older children.
