<s>[INST] 17 yr old son, hit his right knee hard on pole of bed, instantly had severe headache, passed-out (fell asleep?), body jerked & eyes rolled for about 4 seconds, woke up with his face a little pale and can t remember what happened.... as if he just fell asleep, and no more headache. About 5 months ago, he said he also passed-out when he massaged his right shoulder and and felt something clicked . He woke up...as if he fell into a deep sleep. We re not sure if he had seizure before he woke up because he was alone in the house playing his favorite video game. Recent EEG showed abnormality but MRI and MRA are normal. Is this an epileptic attack? If so, what type of epilepsy is this and what is the appropriate medication and care for this condition? Thnks! [/INST] Hello Libya, The latest episode your son has had is suggestive of Pain induced Syncope. All the features described is fitting with a Syncope including the brief unrolling of eyes and jerks and waking up quickly without much confusion. The earlier episode while he was playing the Video game is more difficult to comment on as there were no eyewitnesses, and we are not exactly sure about the duration of the event.(how long he remained unconscious) Even this episode could have been brought on by Pain-the shoulder click.  In Seizures many a time the EEG & MRI Brain can be Normal. The only worrying thing is the abnormality in the EEG. You could take a second opinion about the EEG to see if it's a significant abnormality. I say this because antiepileptic treatment is long term and hence we need to be reasonably sure about the diagnosis before medications are started. What is certain is that your son has tendency to lose consciousness when he encounters pain. He could lie down immediately in such circumstances or flex his legs close to the chest in a sitting position to avoid falls. I think you could wait on starting medications as the evidence is not overwhelming in favor of a Seizure. Discuss with your doctor regarding precautions you can take to avoid Syncope other than the ones I have mentioned above. Hope this helps! </s>