No Tonic-clonic Movements in Pediatrics — 8yo Child | Pediatric Emergency | SMLE Q#17483

SMLE Question #17483

Pediatrics Pediatric Emergency

Objective: OBJ-OPH-REFERRAL-001

Last updated: February 2026
An 8-year-old girl collapses briefly while standing during a crowded outdoor school assembly on a hot day. She had been in the sun for 45 minutes and had not drunk water since morning. Witnesses report pallor before collapse, with no tonic-clonic movements, tongue biting, or urinary incontinence. She regained consciousness within 1 minute and is now at baseline with a normal neurologic examination. Which historical feature is most concerning for a cardiac cause of syncope and warrants urgent evaluation?

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