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It can be difficult but there are some characteristics which are mostly seen in one or the other. It will help to:
• Get a good description of the event and/or a video of it to show the neurologist. This is always one of the most helpful things you can do from a diagnostic point of view.
• Check if you can stop or start the event – if you can, then it is more likely to be behavioural.
• Consider patterns when the event starts, for example does it happen at the same time of day (seizures) or involve the presence of certain people or situations (behaviour)?
• Ask yourself if there was a change in awareness and responsiveness? These changes happen during seizure activity.
• Think about whether the events are the same or different each time. Seizures are usually very similar whereas behaviour can vary greatly.
• Time it as most seizures last less than three minutes but behaviour can last a lot longer.
• Notice how is the person afterwards? After seizures, there is often a period of confusion and tiredness.
If unsure, you have to assume it is seizure activity and follow their seizure management plan and provide seizure first aid as required.