dizziness, vertigo, and seizures may be confused with syncope, a careful history can usually distinguish between these conditions. Dizziness and vertigo do not lead to loss of consciousness, and seizures generally are accompanied by aura, rhythmic involuntary movements, postictal confusion, and, occasionally, urinary and fecal incontinence; a history of tongue biting is helpful for ruling in, but not ruling out, a seizure diagnosis.