Evaluation of the first episode of a possible fit in a child

It is very important to evaluate the first possible fit in a child as accurately as possible because misdiagnosis at the initial stage is a serious and common problem. This article sets out some of the common differential diagnoses presenting as a possible epileptic seizure in the modern hospital-based practise, emphasising features in the history and examination that point towards a specific diagnosis. A scheme for appropriate use of investigations is suggested. An early referral for a specialist opinion is advised where the diagnosis is uncertain.