Because syncope is seizure-like and some symptoms are similar to epilepsy, such as loss of consciousness, dilated pupils, and even convulsions and diaphoresis, it can be easily misdiagnosed as epilepsy. The following points can be used for reference in the differential diagnosis. ( 1 ) Triggers: Most syncope has obvious triggers, while epilepsy has sudden seizures without obvious triggers. ( 2) Position: Syncope mostly occurs in the standing position, partly in the sitting position, and rarely in the lying position, while epilepsy does not necessarily occur. Fainting seizures are usually slow to fall, while epileptic collapse occurs suddenly. ( 3 ) Prodromal symptoms: Syncope is often preceded by prodromal symptoms, such as dizziness, blurred vision, pallor, and abdominal discomfort, whereas pediatric epilepsy is less common. ( 4 ) Difference between syncope and aphasic seizure: The latter starts and stops suddenly, is brief and does not fall down, and has no prodromal symptoms or postictal discomfort. ( 5) Difference between syncope and grand mal seizure: In syncope, the face is pale, the blood pressure is lowered, and the pulse is slow and weak. In contrast, grand mal seizures are cyanotic, blood pressure is not low, and pulse rate increases. Biting of the tongue and urinary incontinence are rarely seen in syncope but mostly in grand mal seizures. Convulsions due to syncope are rare, and if they do occur, they are very short, usually within 15 seconds, while grand mal convulsions are relatively long. There is apnea in grand mal seizures but not in syncope. Postictal drowsiness and positive neurological signs are often present in grand mal seizures, but not in syncope. ( 6 ) EEG: In syncope seizures are mainly slow waves, after syncope seizures EEG is normal, while epilepsy mostly has corresponding discharge waves. ( 7 ) Other: e.g. blood glucose check can diagnose hypoglycemic syncope, and cardiac examination can help diagnose cardiogenic syncope.