Seizure First Aid: How to Respond When Someone Has An Episode

Curated by Claudia Shannon / Research Scientist / ishonest

Overview

If someone you know experiences an epileptic seizure, it can make a huge difference if you know how to help them. Epilepsy is actually a range of disorders affecting the electrical activity of the brain. There are many different types of epilepsy. Most are characterized by unpredictable seizures. But not all seizures will produce the dramatic convulsions most people associate with the disease.

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In fact, the classic seizure, in which a patient loses muscle control, twitches, or falls unconscious, is just one type of seizure. This sort of seizure is called a generalized tonic-clonic seizure. But it represents just one of many forms of epilepsy. Doctors have identified more than 30 different types of seizures.

Some seizures may be less obvious, affecting sensations, emotions, and behavior. Not all seizures involve convulsions, spasms, or loss of consciousness. One form, called absence epilepsy, is usually characterized by brief lapses in consciousness. Sometimes, an outward physical sign such as rapid eye blinking may be the only indication that this type of seizure is occurring.

By definition, a single seizure event does not constitute epilepsy. Rather, a person must experience two or more unprovoked seizures, 24 hours or more apart, to be diagnosed with epilepsy. “Unprovoked” means the seizure is not due to a drug, toxin, or head trauma.

Most people with epilepsy will probably be aware of their condition. They may be taking medications to control their symptoms, or undergoing diet therapy. Some epilepsy is also treated with surgery or medical devices.

Someone you know is having a seizure—What do you do?

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If someone close to you suddenly has a convulsive seizure, there are certain things you can do to help them avoid any additional damage. The National Institute of Neurological Disorders and Stroke recommends the following sequence of actions:

  1. Roll the person over onto their side. This will prevent them from choking on vomit or saliva.
  2. Cushion the person’s head.
  3. Loosen their collar so the person can breathe freely.
  4. Take steps to maintain a clear airway; it may be necessary to grip the jaw gently, and tilt the head back slightly to open the airway more thoroughly.
  5. Do NOT attempt to restrain the person unless failing to do so could result in obvious bodily harm (e.g. a convulsion that occurs at the top of a stairway, or the edge of a pool).
  6. Do NOT put anything into their mouth. No medicines. No solid objects. No water. Nothing. Despite what you may have seen on television, it is a myth that someone with epilepsy can swallow their tongue. But they could choke on foreign objects.
  7. Remove sharp or solid objects that the person might come into contact with.
  8. Time the seizure. Take note: How long did the seizure last? What were the symptoms? Your observations can help medical personnel later. If they have multiple seizures, how long was it in between seizures?
  9. Stay by the person’s side throughout the seizure.
  10. Stay calm. It will probably be over quickly.
  11. Do NOT shake the person or shout. This will not help.
  12. Respectfully ask bystanders to stay back. The person may be tired, groggy, embarrassed, or otherwise disoriented after a seizure. Offer to call someone, or obtain further assistance, if they need it.

When to seek medical help

Not all seizures warrant immediate medical attention. Sometimes you may need to call 911, though. Call for emergency help under the following circumstances:

  • The person is pregnant, or diabetic.
  • The seizure happened in water.
  • The seizure lasts longer than five minutes.
  • The person does not regain consciousness after the seizure.
  • The person stops breathing after the seizure.
  • The person has a high fever.
  • Another seizure begins before the person regains consciousness following a previous seizure.
  • The person injures himself during the seizure.
  • If, to your knowledge, this is the first seizure the person has ever had.

As well, always check for a medical identification card, a medic alert bracelet, or other jewelry that identifies the person as someone who has epilepsy.

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