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November 6, 1991

Fits and Faints

Author Affiliations

Children's Mercy Hospital Kansas City, Mo

Children's Mercy Hospital Kansas City, Mo

JAMA. 1991;266(17):2472-2473. doi:10.1001/jama.1991.03470170164045

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A toddler bumps her head, becomes pale, and silently slumps to the floor. When her mother picks her up, the child stiffens, then jerks a few times.

A retarded teenaged boy with the diagnosis of refractory epilepsy comes to the emergency department after another one of his "seizures." In the hospital the doctor sees him hold his breath, collapse, and have a brief convulsion.

A young woman complains of strange feelings that are occasionally followed by a brief convulsion. Careful interviewing reveals the attacks are often triggered by a startling event, such as a ringing alarm clock.

The above vignettes illustrate problems that fall loosely into the category of "seizures." Since the word implies epileptic seizure to American physicians, a less misleading term would be "spells." None of the above people had epilepsy as the primary cause of their spells. The first had pallid infantile syncope, the second self-induced anoxic