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Handling A Seizure

10 February 2021 | 6 mins read | Handling A Seizure

Epilepsy, a seizure disorder, affects from 0.5% to 1% of all people at some point in their lives. Read about the condition here.

Would you know what to do if someone you know has a seizure?

How Would I Recognize A Seizure?

Seizures can be very broadly divided into 2 categories, although there are many different types of seizures, and they have a very wide range of appearances.

  • Focal seizures

During a “focal” seizure you might see twitching, jerking, repetitive or unusual behaviors, or hear about a hallucination or paranoid thoughts. The person remains seated or even standing. The person is either fully conscious and aware or is only partially aware and seems dazed and confused. Most focal seizures last for less than two minutes.

  • Generalized seizures

The person is unaware of the seizure. At one end of the spectrum, during an “absence” seizure the person seems ‘zoned out’ for a few seconds. At the other end, during a tonic-clonic seizure the person will fall if standing, will make rhythmic jerking movements, and may make gasping, snuffling, or other noises.

Sometimes people have a sense that they are about to have a seizure and will tell you. If someone tells you that they feel a seizure is going to happen, ask them if they have rescue medication they should immediately take, or a nerve stimulator that they can use.

Preventing recurrent seizures, particularly seizures in which the person is unaware of the seizure, is extremely important in preventing further damage to the brain, and possibly even death.

Related reading:

how do i help someone having a seizure? halza digital health app
How Do I Help Someone Who Is Having A Seizure?

First of all, stay calm. This seems obvious but is worth saying. You can’t help someone if you are panicking.

If this is the person’s first seizure, or if you see a stranger having a seizure of which they are unaware, call an ambulance.

If the person is aware of the seizure, or if they are conscious but confused and not fully aware, help them to sit down if possible. Know that their senses, including vision, might be impaired, and that they might have hallucinations. Speak quietly to them and reassure them that you are there and that they are alright. Guide them away from danger, such as a swimming pool or open fire. Stay with them until they are fully alert and understand what happened.

If the person is unaware of the seizure:

managing a seizure time the seizure epilepsy halza digital health medical app family medical records

  • Time the seizure. A generalized seizure lasting five or more minutes is a medical emergency requiring an ambulance.
  • During the clonic (jerking or spasming) phase of a generalized seizure do not touch the person unless they are directly in harm’s way. Make sure that the immediate area is safe, such as by moving sharp, hard, or breakable objects.
  • Do not put anything into their mouth.

what to do when someone is having a seizure position the person for safety halza digital health app medical records epilepsy

Position the person for safety:

  • As the clonic (jerking) phase subsides and the person relaxes, check for signs of obvious injury, especially if the person has fallen onto a hard floor.
  • If the person is on the floor, roll them onto their side using their shoulder and hip. A bent top leg and an outstretched bottom arm will provide stability. Placing them on their side allows excess saliva to drip out rather than being inhaled.
  • Place a folded blanket, towel, or other soft cloth under their head. Avoid using a soft pillow which can interfere with breathing.
  • Lift their chin away from the chest so that their mouth is angled towards the floor and their airway is clear. This will also help to prevent them from inhaling saliva or vomit.
  • Loosen any clothing around the neck.

If the person is safely in a chair or wheelchair, don’t move them from the chair. Angle their head to the side so that it is not drooping forward.

After the seizure movement has ended and you have properly positioned them:

  • The person should regain consciousness within 5 minutes. Tell them you are there, and that they are ok. Then they will most likely fall asleep. Let them sleep.
  • Stay with the person until they are awake and alert (or make sure someone else responsible can stay).
  • Once they are awake, they may be confused for a while or have no memory of the seizure. Help to re-orient them. They might have a headache, sore muscles, a sore cheek or tongue if they bit it, or feel sad or embarrassed. It is important to provide reassurance that they are alright.
  • Before you leave, make sure they are fully alert by asking questions that require more than a yes/no/I’m fine response.

should i call an ambulance when someone is having a seizure halza digital health app medical records
Shouldn’t I Call an Ambulance?

Most seizures do not require medical treatment. However, do call an ambulance if:

  • This is the person’s first seizure.
  • You don’t know if the seizure is an epileptic seizure.
  • A tonic-clonic seizure has lasted for five minutes.
  • The seizure stops but the person has not regained consciousness after 5 minutes.
  • Another seizure occurs before the person has regained consciousness.
  • Another seizure occurs within 30 minutes.
  • An absence or focal seizure with loss of awareness lasts for more than 10 minutes.
  • The person was in the water.
  • The person is injured.
  • The person is pregnant.
  • The person has diabetes.

The longer a seizure lasts, the less likely it is to resolve on its own, increasing the risk of brain damage or death.

Related reading:

Every seizure is different. Since you can’t know when, where, or to whom a seizure will happen, it’s hard to feel fully prepared. But now that you know the most important things to do – and not to do – you can feel confident that you will help the person to be safe.

Sources: UpToDateEpilepsy Foundation, 2, 3, 4