1, syncope The onset of syncope is dominated by disorders of consciousness; anxiety, pain, blood, excessive cold, hyperthermia induced, appear when standing or sitting, rarely in the recumbent position especially in sleep; loss of consciousness is often preceded by dizziness, black eyes, abdominal discomfort and panic symptoms, syncope is often accompanied by pallor and reduced blood pressure; loss of consciousness is rarely accompanied by convulsions, lying down consciousness soon resumes; EEG normal. Primary syncope: patients often have a history of arrhythmia, but care should be taken to distinguish whether the patient is suffering from arrhythmia-induced impaired consciousness or epilepsy-induced impaired consciousness. be differentiated. The main difference between syncope and tonic-clonic seizure: the former is a transient and diffuse ischemia caused by insufficient cerebral blood supply, so its “absence” symptoms are more than stimulation symptoms, and weakness and hypotonia of the limbs are more common than tonic and clonic syncope: the former often has a fall, and the onset and recovery are slower than the latter. There is a clear post-ictal state. 2, hysteria: mostly seen in young women, consciousness, no self-injury, accidental injury and urinary incontinence; seizures are mostly related to psychiatric factors, often with crying or shouting; seizure form is variable, dramatic flushing, normal pupils; AEDs are ineffective, discontinuation does not induce; EEG without epileptiform discharges, Video-EEG helps to confirm the diagnosis. 3, TIA: Mostly seen in the elderly, mostly with a history of hypertension, diabetes mellitus, atherosclerosis; TIA of the internal carotid system with simple partial seizures; TIA of the vertebral basilar system with dystonic seizures. EEG without epileptic discharges. 4, episodic hypoglycemia History of diabetes mellitus, visible impairment of consciousness, psychiatric symptoms, extremely similar to complex partial seizures; seizures are mostly in the early morning and last for a long time; EEG shows diffuse slow waves and decreased blood glucose during seizures; oral or sedative glucose can rapidly relieve. 5. Narcolepsy is a sudden onset of uncontrollable sleep, in which the patient falls asleep rapidly regardless of the occasion or location; there may be sleep paralysis, pre-sleep hallucinations and sudden collapse disorder, and the patient’s sudden fall is easily misdiagnosed as a seizure, but there is a family history of the disease. 6, breath-holding seizures within 5 years of age, especially 6-18 months of age, often preceded by fright, anger, crying, etc.; appear whistling phase breath-holding, cyanosis or pallor; a few children with loss of consciousness and general tonicity, even limb twitching, may have urinary incontinence general seizures do not exceed 1 minute. No special treatment. 7, emotional cross-legged seizures Commonly seen in 1-3 years old female children, the seizure of double thighs cross clenching, accompanied by rubbing action, facial flushing, eyes staring, but always clear consciousness; usually 1-2 minutes can be relieved by itself, distraction can stop, or can be forcibly stopped by the outside world. It is related to inflammatory stimulation of the vulva and can be reduced by paying attention to vulva cleanliness. EEG is normal. 8, non-epileptic tonic seizures Common in infancy, waking state onset, various forms, short duration, seizures are mostly limited to the eyes, mouth and head and neck, manifested as: staring, clenching teeth, head and neck stretching and swinging from side to side, no loss of consciousness. It can be interrupted by external stimuli. EEG is normal. 9. Sleepwalking disorder is most common in school-age children. However, part of nocturnal sleepiness is a manifestation of temporal lobe epilepsy. The onset of the syndrome is currently thought to be genetically related, with psychiatric and infectious factors as triggers; it commonly occurs in school-age male children, and is a rapid, involuntary, repetitive contraction of a muscle group or muscle in the body, most often involving the face and head and neck muscles. It can also involve limb-girdle muscles. Clinical manifestations are: blinking, eyebrow raising (eyebrow squeezing), tilting of the mouth, head bobbing, shoulder shrugging, or rapid shaking of the limbs. If the inspiratory muscles, pharyngeal muscles, and septal muscles are involved, the symptoms may manifest as brief episodes of vocalization and eructation. EEG monitoring is normal. 11. REM sleep behavior disorder is common in 60-70 y old people, but can start at any age. It is common in males and occurs during REM sleep, so it occurs about 90 min after sleep onset, about once a week, or more than 4 episodes per night for several days in a row. Sleep EEG shows high muscle tone without loss of muscle tone; can be treated with clonazepam, antidepressants, AEDS, dopamine 12, episodic movement-triggered dyskinesia No family history of patients, the onset is often between 1 and 20 years old; there is a clear trigger for movement, such as sudden movement, jumping, standing, etc., the seizure manifests as dystonia, dance-like; tachycardia, torso twisting and There is no loss of consciousness, pain, myoclonus, tongue bite and urinary incontinence during the seizure, and the seizure can be traced after the seizure; other organic diseases are excluded and the neurological examination is normal; anticonvulsant medication is mostly effective. The duration of each seizure is short (mostly within 1 min). Other causes include encephalitis, perinatal hypoxia, cystinuria, parathyroidism, pseudohypoparathyroidism, hyperthyroidism, thyrotoxicosis, TIA, head trauma, hypoglycemia, basal ganglia calcification, AIDS, diabetes mellitus. The episodes can last from a few minutes to a few hours, and can last for more than a day, usually 5 minutes to 4 hours, with a low frequency of several episodes per year to several per day. There is no loss of consciousness during the seizures; the interictal neurological examination is normal and the EEG is normal; the family history is consistent with autosomal dominant inheritance and the gene locus 2q31-36 is not effective with medication, but clonazepam may be effective; Lee suggests that immune mechanisms play a role.