Which of the following is a sign of an impending seizure?

Signs of an impending seizure often include changes in level of consciousness. Before a seizure occurs, a person may exhibit alterations in awareness, responsiveness, or alertness, which can manifest as confusion, drowsiness, or a change in their usual behavior. This phase, known as the prodromal or preictal stage, is significant as it may provide clues to caregivers or healthcare providers that a seizure is about to occur.

In contrast, while convulsions can happen without an aura, they are typically a result of the seizure itself rather than a warning sign. Loss of hearing might occur in various medical conditions but is not a classic sign specifically associated with seizures. Presence of fever alone can indicate infection or illness, but does not directly signal that a seizure is imminent. Recognizing changes in level of consciousness is therefore vital in anticipating and managing a seizure effectively.