The differential diagnosis of episodes of transient loss of consciousness can be straightforward but can also present some of the greatest diagnostic difficulties. In most circumstances, when there is uncertainty, usually when there have been only one or a few poorly observed events, it may be reasonable to admit to that uncertainty and await any further events to clarify the diagnosis. We have reason to know from bitter experience that this is not always the case and that more rigorous consideration of investigation may be justified rather than allowing the passage of time to clarify the diagnosis.
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