Neurologists must distinguish between spells that are epileptic seizures (and require treatment with anti-epilepsy medication or surgery) and spells from another cause (that require a completely different treatment plan). The possible causes tend to vary with age. In infancy, some other causes of seizure-like spells include:

• breath-holding spells
• apnea
• gastroesophageal reflux (Sandifer’s syndrome)

In later childhood:

• sleep disorders
• tic disorders
• behavioral inattention
• migraines
• hyperekplexia (startle attacks),
• episodic dyskinesias or ataxias

In teenagers and adults:

• syncope (fainting)
• psychogenic seizures (stress-related seizures)
• sleep disturbances
• sleep apnea
• cardiac rhythm disturbances
• migraines