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It is very important to recognize when the person has a seizure. You probably know some people with epilepsy.

What To Do When Someone Has A Seizure?

Watching someone having an epileptic attack is very frightening, so yes, everybody should know more about seizures and symptoms. If a friend or a family member has epilepsy, you should know what to do in that situation. If you recognize someone having a seizure you can help that person. Knowing what to do and what not to do when someone has a seizure is very important. In the majority of epileptic seizures, seizures last only a few minutes and do not require medical attention.

Seizures are paroxysmal episodes of sudden, involuntary muscle contractions and alterations in consciousness, behavior, sensation, and autonomic functioning. The episodes may be partial simple or complex or generalized absence, myoclonic, tonic, clonic, tonic-clonic and are labeled epilepsy if they are recurrent. [1]

Symptoms Of A Seizure

Help required during seizures depends on:

  • The type of seizure
  • How long the seizure lasts
  • How the seizure affects the person's consciousness
  • How severe it is. [1]

A person watching an epileptic attack should carefully note the nature of the seizure to tell the doctor. Symptoms of an epilepsy seizure can be:

  • Motor
  • Psychic 
  • Sensory 

Motor symptoms include repetitive involuntary muscle contractions of one body part (face, finger, hand, or arm) that may spread to other or same-side body parts. 

Psychic symptoms include a sensation of deja vu, complex hallucinations or illusions, unwarranted anger or fear, pupillary dilation and sweating.

Sensory symptoms are auditory or visual hallucinations, paresthesias, and vertigo. 

Some people may have an aura before a seizure. An aura could include a patting of body parts, smacking lips, aimless walking, picking at clothes, unintelligible muttering, and a staggering gait. Right before a seizure, a person may have 1 to 2 minutes of loss of contact with surroundings and hallucinations. 

How To Recognize When Someone Is Having A Seizure?

Seizures may occur several times a day to one every few years.

Emotional disturbances may also cause seizures. Some people have strange visual effects (auras) before a seizure, but others have no warning symptoms.

Seizures can occur during sleep or after stimulation, such as a blinking light or a sudden loud sound.

Most epileptic attacks are brief. They may affect the entire body or a small area. The muscles may contract and relax violently or only twitch slightly.

Mental confusion and tiredness can last for several minutes or hours or days. Petit mal attacks are marked by a loss of consciousness for several seconds and eye or muscle fluttering. Grand mal seizures are the classic muscle contractions involving the entire body, loss of consciousness, and often loss of bowel control. Drowsiness or confusion often follow seizures. Some seizures may require basic first aid.

A person with generalized absence could have a temporary loss of consciousness, flickering of the eyelids or intermittent jerking of the hands.

A person with myoclonic seizures may have rapid, jerky movements in extremities or over the entire body, which may cause a fall.

Someone with tonic seizures could have a sudden abnormal dystonic posture, deviation of eyes and jerk their head to one side.

A person with clonic seizures may have symmetric jerking of the extremities for several minutes with a loss of consciousness.

A person with tonic-clonic may have an aura of epigastric discomfort, outcry, loss of consciousness, cyanosis, fall, tonic then clonic contractions, then limpness, sleep, headache, muscle soreness, confusion, and lethargy, and loss of bowel and bladder control. The person could also have irregular breathing and a blue tinge around the mouth.[2]

What Should You Do When Someone Is Having A Seizure?

  1. During a seizure, there are safety precautions to prevent injury, and you should [3]:
    1. Loosen restrictive clothing.
    2. Roll the person on one side to prevent aspiration.
    3. Place a small pillow under the head and ease them from a standing or sitting position to the floor.
    4. Don't move the person unless he or she is in immediate danger.
    5. Move furniture or any other objects that hat might injure the person during the seizure.
    6. If a person having an attack is standing, prevent him or her from falling if you can, or try to guide them to the floor gently.
    7. If the person with epilepsy is already on the ground, try to position the person on his or her side (recovery position) so that fluid can leak out of the mouth. However, do not apply pressure to the individual's body because you may cause an injury.
    8. You shouldn’t place a finger or other object into the individual's mouth to protect or straighten the tongue — it is unnecessary and dangerous unless an object is obstructing the breathing pathway.
  2. If the person is unconscious, make sure nothing is blocking the nose or mouth. Put the person in the recovery position. Clear person's mouth if necessary. 
  3. Don't perform artificial respiration during a seizure, even if the person is turning blue. Most seizures are very brief (up to 2 minutes) and over long before brain damage from lack of oxygen begins.
  4. You should not try to hold the person still because you may injure the individual or yourself.
  5. If the person has vomited, you should roll the person on his side so that any fluid can easily flow out of the mouth and not obstruct breathing.
  6. If the person has a seizure, they may not hear you.
  7. Don’t give the person anything to eat or drink until the person fully recovers.
  8. Don't give the person medication by mouth until the seizure has stopped and he or she is completely awake and alert.
  9. You should be calmly reassuring. When you are watching an epileptic attack, you should stay very calm and try not to panic.
  10. Stay with the person until recovery is complete.
  11. You should maintain a patent airway, note frequency, type, time, affected body parts, and length of seizure.
    Monitoring vital signs and neurologic status is critical.
The medical community highly recommends that a person with epilepsy wears a Medic-Alert tag.

What Should You Do When A Seizure Stops?

  • After a minute or two, the seizure and jerking movements should stop.
  • After the seizure, you should gently turn the person's head to the side to let the saliva flow out of the mouth.
  • Let the person rest or sleep. After a seizure ends, most people sleep deeply. 
  • Be reassuring and calm as awareness returns.
  • When the person awakens, he or she may feel disoriented for a while. You should repeat any information the person has missed during the seizure. [3]

Complications may occur as a result of the onset of seizure activity and can include injury from a fall or jerking, as well as airway occlusion and aspiration. You could help and prevent these complications if you learn how.

You should know that a condition also known as status epilepticus, in which motor sensory or psychic seizures follow one another with no intervening periods of consciousness, is a medical emergency. Status epilepticus is usually convulsive. The seizures persist for 30 minutes or more. The airway occlusion and aspiration combined with muscular contractions during a seizure puts stress on the cardiovascular system. The lack of oxygen may lead to brain damage. If the person doesn’t get immediate treatment they may have hypoxia, hyperthermia, hypoglycemia, and acidosis. That may cause death. You could save someone’s life. [4

When To Call A Doctor About A Seizure?  

Call a doctor if you know this is the person's first seizure.

If the seizure last more than five minutes or one seizure follows another without the person regaining consciousness between them you should call an ambulance.

If the person is injured during the seizure you should call a doctor. If the person is pregnant, has diabetes, or has high blood pressure you should find medical help. If the person has a seizure in water, call a doctor. [5]

When you help someone, you will feel better. When you know how to help, you should always help someone with a health problem.      

While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Once epilepsy is diagnosed, it is important to begin treatment as soon as possible.

In about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques.