Table 1

Clinical distinction of reflex (vasovagal) syncope from seizures

Syncope Seizure
TriggerCommon (upright, bathroom, blood, needles)Rare (flashing lights, hyperventilation)
ProdromeAlmost always (presyncope)Common (aura)
OnsetGradual (often minutes)Usually sudden
Duration1–30 seconds1–3 minutes
Convulsive jerksCommon (brief)Common (prolonged)
IncontinenceUncommonCommon
Lateral tongue biteVery rareCommon
ColourVery palePale (simple partial seizure) Red, blue (tonic-clonic seizure)
Post-ictal confusionRare (eg, wakes on floor)Common (eg, wakes in ambulance)
RecoveryRapid (quickly orientated)Slow (confused)