In a first-seizure or transient-loss-of-consciousness clinic, the single most valuable piece of information is one the patient does not have. They were unconscious. What they can tell you is the run-up and the aftermath, and those are worth taking carefully — but the event itself belongs to whoever was in the room.
So get the witness on the phone during the consultation rather than accepting a relayed account. Ask them for duration by anchoring it to something — how much of the programme had finished, whether the kettle had boiled — because time estimates during a frightening event are unreliable and almost always too long. Ask what the eyes were doing, whether the stiffening came before the shaking, and what colour the face went. Then ask how long it took before the person said something sensible, which separates a prolonged post-ictal state from a faint with a brief myoclonic jerk.
A five-minute call routinely does more diagnostic work than the EEG that follows, and it is far easier to make at the first visit than at the third.
- Phone the witness during the consultation rather than relying on a relayed account
- Anchor duration to an external event rather than asking for minutes
- Ask the order of events: stiffening before shaking, or shaking alone
- Ask how long until the person spoke sensibly — that separates post-ictal from syncope
Why it matters
The diagnostic information sits with the person who was watching, and it degrades fast with every retelling.
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