Malcolm Lowry presents to the ED of the Hamilton General Hospital accompanied by his wife, Vita. He is seen by a second-year resident in Emergency Medicine and a clinical clerk. Mr. Lowry is a 47-year-old businessman. This afternoon, he collapsed in front of his wife, who observed that both arms and legs were shaking and that his eyes were rolled back. After 30-60 seconds the shaking stopped, but he was unresponsive for several minutes and remained drowsy and confused for half an hour. Vita called 911 and Malcolm was taken to the Emergency Department. The patient states that this has never happened to him before. He had no warning symptoms prior to collapsing. He does not remember collapsing. He did not soil himself or bite his tongue, but his muscles are sore. His past health has been good. He does not have hypertension, diabetes or other chronic health problems. He has never been hospitalized and he is not on any medications. He denies recent head trauma, febrile illness, headache or neurological symptoms. He has no family history of epilepsy. Vita states that Malcolm has been drinking alcohol heavily for a number of months but stopped two days ago after she removed all the alcohol from the house. Today he was so tremulous that he could hardly button his shirt. Malcolm points out that he has stopped alcohol for a day or two several times in the past few months, and although he has felt shaky he has never had a seizure.