A 5 years old boy presents with frequent unusual episodes for the past 3 months. The unusual episodes consist of sudden activity arrest with staring and minimal eyelid flutter for 10 to 20 seconds occurring multiple times per day. The patient is unresponsive to voice or tactile stimulation during the episodes. He is able to immediately resume activities without any recollection of the event once the episode finishes. His teachers have noted that he stares off in class repeatedly and does not seem to be remembering instructions and classroom material. He also no significant past medical history. What are the most important differential diagnoses?

Of the relevant differential diagnoses, it is important to rule out brain tumor, transient ischemic attack, narcolepsy and cataplexy.

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This post was written by Omar Rifai