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Transient loss of consciousness (TLOC) – spontaneous disruption of consciousness with complete recovery not due to head trauma [1] – has a lifetime prevalence of 50% [2] and accounts for 3% of all emergency department (ED) attendances in the United Kingdom (UK) [3]. Over 90% of presentations are due to epileptic seizures (ES), syncope, or psychogenic non-epileptic seizures (PNES) [4]. Accurately distinguishing between these is vital to allow appropriate management and identification of patients at risk of morbidity/mortality from different underlying conditions [3–5].