If you see someone having a seizure or fit, there are some simple things you can do to help. You should call an ambulance if you know it is their first seizure or it is lasting longer than 5 minutes.
It might be scary to witness, but do not panic.
If you are with someone having a seizure:
- only move them if they are in danger – such as near a busy road or hot cooker
- cushion their head if they are on the ground
- loosen any tight clothing around their neck such as a collar or tie, to aid breathing
- when their convulsions stop, turn them so they are lying on their side – read more about the recovery position
- stay with them and talk to them calmly until they recover
- note the time the seizure starts and finishes
If they are in a wheelchair, put the brakes on and leave any seatbelt or harness on. Support them gently and cushion their head, but do not try to move them.
Do not put anything in their mouth, including your fingers. They should not have any food or drink until they fully recover.
Key Facts
- Symptoms of seizures may include uncontrollable, jerky movement of arms and legs, unconsciousness, lack of awareness, anxiety and fear
- The most common cause of seizures is epilepsy
- Other causes include head trauma, brain tumor, high fever, lack of sleep, stroke, some medication
- Prevention steps may include correct use of medication, being active, exercising and getting enough sleep
- Treatment options include medication, surgery, vagus nerve stimulation, responsive neurostimulation, deep brain stimulation and diet therapy
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Symptoms
With a seizure, signs and symptoms can range from mild to severe and vary depending on the type of seizure. Seizure signs and symptoms may include:
- Temporary confusion
- A staring spell
- Uncontrollable jerking movements of the arms and legs
- Loss of consciousness or awareness
- Cognitive or emotional symptoms, such as fear, anxiety or déjà vu
Doctors generally classify seizures as either focal or generalized, based on how and where abnormal brain activity begins. Seizures may also be classified as unknown onset, if how the seizure began isn’t known.
Diagnosis
After a seizure, your doctor will thoroughly review your symptoms and medical history. Your doctor may order several tests to determine the cause of your seizure and evaluate how likely it is that you will have another one.
Causes
Nerve cells (neurons) in the brain create, send and receive electrical impulses, which allow the brain’s nerve cells to communicate. Anything that disrupts these communication pathways can lead to a seizure.
The most common cause of seizures is epilepsy. But not every person who has a seizure has epilepsy. Sometimes seizures happen because of:
- High fever, which can be associated with an infection such as meningitis
- Lack of sleep
- Low blood sodium (hyponatremia), which can happen with diuretic therapy
- Medications, such as certain pain relievers, antidepressants or smoking cessation therapies, that lower the seizure threshold
- Head trauma that causes an area of bleeding in the brain
- Stroke
- Brain tumor
- Illegal or recreational drugs, such as amphetamines or cocaine
- Alcohol abuse, during times of withdrawal or extreme intoxication
Prevention
Here are some steps you can take to help with seizure control:
- Take medication correctly. Do not adjust the dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor.
- Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night.
- Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly if you have another seizure.
- Be active. Exercising and being active may help keep you physically healthy and reduce depression. Make sure to drink enough water and rest if you get tired during exercise.
Make healthy life choices. Managing stress, limiting alcohol.
Not everyone who has one seizure will have another one, and because a seizure can be an isolated incident, your doctor may not decide to start treatment until you’ve had more than one.
The optimal goal in seizure treatment is to find the best possible therapy to stop seizures, with the fewest side effects.
Medication
Treatment for seizures often involves the use of anti-seizure medications. Several options exist for anti-seizure medications. The goal is to find the medicine that works best for you and that causes the fewest side effects. In some cases, your doctor might recommend more than one medication.
Surgery and other therapies
If anti-seizure medications are not effective, other treatments may be an option:
- Surgery. The goal of surgery is to stop seizures from happening. Surgeons locate and remove the area of your brain where seizures begin. Surgery works best for people who have seizures that always originate in the same place in their brains.
- Vagus nerve stimulation. A device implanted underneath the skin of your chest stimulates the vagus nerve in your neck, sending signals to your brain that inhibit seizures. With vagus nerve stimulation, you may still need to take medication, but you may be able to lower the dose.
- Responsive neurostimulation. During responsive neurostimulation, a device implanted on the surface of your brain or within brain tissue can detect seizure activity and deliver an electrical stimulation to the detected area to stop the seizure.
- Deep brain stimulation. Doctors implant electrodes within areas of your brain to produce electrical impulses that regulate abnormal brain activity. The electrodes attach to a pacemaker-like device placed under the skin of your chest, which controls the amount of stimulation produced.
- Dietary therapy. Following a diet that is high in fat and low in carbohydrates, known as a ketogenic diet, can improve seizure control. Variations on a high-fat, low-carbohydrate diet, such as the low glycemic index and modified Atkins diets, though less effective, aren’t as restrictive as the ketogenic diet and may provide benefit.
When to call an ambulance
Call for an ambulance if:
- It is the first time someone has had a seizure
- the seizure lasts for more than 5 minutes
- the person does not regain full consciousness, or has several seizures without regaining consciousness
- the person is seriously injured during the seizure
People with epilepsy do not always need to go to hospital every time they have a seizure.
Some people with epilepsy wear a special bracelet or carry a card to let medical professionals and anyone witnessing a seizure know they have epilepsy.
Make a note of any useful information
If you see someone having a seizure, you may notice things that could be useful for the person or their doctor to know:
- What were they doing before the seizure?
- Did the person mention any unusual sensations, such as an odd smell or taste?
- Did you notice any mood change, such as excitement, anxiety or anger?
- What brought your attention to the seizure? Was it a noise, such as the person falling over, or body movements, such as their eyes rolling or head turning?
- Did the seizure occur without warning?
- Was there any loss of consciousness or altered awareness?
- Did the person’s colour change? For example, did they become pale, flushed or blue? If so, where – the face, lips or hands?
- Did any parts of their body stiffen, jerk or twitch? If so, which parts were affected?
- Did the person’s breathing change?
- Did they perform any actions, such as mumble, wander about or fumble with clothing?
- How long did the seizure last?
- Did the person lose control of their bladder or bowels?
- Did they bite their tongue?
- How were they after the seizure?
- Did they need to sleep? If so, for how long?
Keeping a seizure diary
If you have epilepsy, it can be helpful to record the details of your seizures in a diary.
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