The initial evaluation should attempt to distinguish the following:

Therefore the following symptoms should be evaluated for (and often requiring verification by available witnesses):

Vertigo - a subjective sensation that the surroundings are moving or spinnning
Seizure - tonic-clonic activity, tongue biting, urinary incontinence, post-ictal confusion

N.B. transient arrhythmias or hypotension occasionally present with seizure-like activity - (take the pulse and perform ECG monitoring during the event!)

Occasionally only Holter monitoring and Video-EEG will achieve diagnostic certainty of the cause.