The differential diagnosis of spells is broad and includes
both innocent and life-threatening conditions with a
considerable overlap in clinical presentation. Extensive
diagnostic testing is often performed, without reaching a
final diagnosis, or resulting in false-positives. A thorough
medical history, including family history and medication,
and physical examination are required to obtain clues
about the cause of a spell. An overview of spells with their stereotypic phenotype in general internal medicine practice is presented in this article. Besides, a diagnostic approach is proposed for the clinical evaluation of spells.