Birth Problems or Trauma Hypoxia or head trauma

D. Infections. Includes meningitis, encephalitis, and neonatal infections, including TORCH.

E. Metabolic Problems. Includes hypoglycemia, hyponatremia or hypernatremia, hypocalcemia, and inborn errors of metabolism.

F. Medications. Anticonvulsants, antidepressants and anxiolytics, lidocaine, theophylline, psychotropic agents, isoniazid, chemother-apeutic agents, cocaine, amphetamines, heroin, PCP, and carbon monoxide.

G. Disorders of Sensation. Child may present with staring spells in school if he or she is unable to see or hear normally. With deficits in special sensory stimulation, child may not know when to respond to environmental stimuli.

H. Disorders of Cognition. If child is unable to understand information presented by his or her surroundings, it is common for child to appear to ignore information. Multilingual children may initially have difficulty understanding the expressive language of their environment if it is different from the language spoken at home.

I. Intoxications. Ingestion of a toxic substance, such as alcohol (methanol, ethylene glycol) or a variety of medications may result in depression of mental status, staring, seizures, or all of these findings.

J. Sleep Disorders. Insufficient or inefficient sleep may result in excessive daytime sleepiness and subsequent alteration of arousal; this may be an isolated diagnosis or a complication of other medical conditions such as obstructive sleep apnea.

K. Behavior Disorders. Child may ignore his or her surroundings as a sign of a mood or conversion disorder. Children with attention-deficit/hyperactivity disorder often present with inattention and apparent staring or daydreaming.

L. Migraine. Children with confusional migraine can present with staring.

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