Hyperreflexia and extensor plantar responses are potential neurologic signs of a recent seizure but should resolve during the postictal period.
Patients with generalized tonic-clonic seizures do not have auras. An aura indicates a focal aware seizure, and a reliable history of aura identifies the seizure as not generalized. Seizures that arise out of sleep (nocturnal seizures) may be hard to distinguish.
The distinction between syncope and seizures can be difficult, because it is based on history alone; however, several symptoms are helpful in aiding the diagnosis. These include the circumstances of the attacks, because the most common mechanism of syncope (vasovagal response) is typically triggered by known precipitants (eg, pain, such that as inflicted by medical procedures; emotions; cough; micturition; hot environment; prolonged standing; exercise). Other historical features that favor syncope include "presyncopal" prodromes (eg, vertigo, dizziness, lightheadedness, chest pain, nausea), as well as age and a history of cardiovascular disease. Historical features that favor seizures include tongue-biting, head-turning, posturing, urinary incontinence, cyanosis, prodromal déjà vu, and postictal confusion.
For more on the presentation of seizures, read here.
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Cite this: Amy Kao, Helmi L Lutsep. Fast Five Quiz: Test Your Knowledge of Various Seizures and Their Causes - Medscape - Apr 03, 2017.