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Transient loss of consciousness (TLOC) has a diverse etiology with a lifetime prevalence of 50% [1]. Differential diagnosis includes syncope, orthostatic hypotension, seizures, psychogenic non-epileptic seizures (PNES), and cardiac arrhythmias [2]. Unfortunately, diagnosis of the underlying cause can be a challenge in the emergency department (ED), where there is a 20-30% misdiagnosis rate for TLOC [3,4,5] with most epileptic seizures wrongly diagnosed as syncope [6]. Overall, syncope accounts for 76% of cases of TLOC [7,8], whereas seizures account for 1% of total ED attendance in the United States[9].