Learn What to Do When Someone is Having a Seizure

According to the Epilepsy Foundation, about 1 out of 10 people may have a seizure during their lifetime. That means chances are you may one day need to help someone during or after a seizure. Your actions can help keep that person safe.

November is National Epilepsy Awareness Month, a time to learn more about epilepsy and ways you can help when someone is experiencing a seizure.

“Epilepsy is a neurological disorder of the brain and seizures are a symptom of epilepsy. People are diagnosed with epilepsy when they have had two or more seizures,” says Dr. William House, Department of Neurology, Baystate Health.

During a seizure a person may not be aware of what is going on or may lose consciousness and could get hurt. Knowing what to do can make a difference and even save a life.

What happens when someone has a seizure?

“Seizures can affect people in different ways, but all seizures have a beginning, middle and end,” says Dr. House. “Some people with seizures are aware of the beginning of a seizure – this is often called an aura, and is a focal seizure with preservation of awareness, also known as a simple partial seizure. It can spread to involve other brain areas and cause a loss of awareness and then becomes a complex partial seizure, the middle phase. When the excessive electrical activity causing the seizure stops, usually within two minutes, a person may be sleepy and not fully oriented – the postictal or end phase. In some people whose seizures start in a more generalized pattern, they may have a so-called premonition, lasting hours or even a day before the clinical seizure starts.”

Not all seizures are the same. Many people with epilepsy have more than one type of seizure.

It can be hard to tell when a person is having a seizure. The person having a seizure may seem confused or look like they are staring at something that isn’t there. Other seizures can cause a person to fall, twitch, and become unaware of their surroundings. The signs of a seizure depend on the type.

Knowing what happened during a seizure and talking about it may help make the seizures less scary.

Major Types of Seizures

1. Generalized seizures which affect both sides of the brain and include:

Absence seizures, sometimes called petit mal seizures, can cause rapid blinking or a few seconds of staring into space.

Tonic-clonic seizures, also called grand mal seizures, can make a person:

• Cry out.
• Lose consciousness.
• Fall to the ground.
• Have muscle jerks or spasms – stiffening of the limbs followed by rhythmic jerking of the limbs.

The person may feel tired after a tonic-clonic seizure.

2. Focal seizures, also called partial seizures, are in just one area of the brain and include:

Simple focal seizures can cause twitching or a change in sensation, such as a strange taste or smell. Complex focal seizures can make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes. Secondary generalized seizures begin in one part of the brain, but then spread to both sides of the brain.

What to Do if Someone is Having a Seizure

Seizure first aid

“The most important thing to do if you see someone having a seizure is to make sure they do not get hurt, for example by falling or walking into unsafe areas. Time the seizure as well. Most focal onset seizures spontaneously stop within about two minutes; most generalized seizures usually spontaneously stop within 4-5 minutes,” says Dr. House.

The Centers for Disease Control and Prevention (CDC) offer the following tips for helping someone during a seizure:

• Ease the person to the floor.
• Turn the person gently onto one side. This will help the person breathe.
• Clear the area around the person of anything hard or sharp. This can prevent injury.
• Put something soft and flat, like a folded jacket, under his or her head.
• Remove eyeglasses.
• Loosen ties or anything around the neck that may make it hard to breathe.
• Time the seizure. Call 911 if the seizure lasts longer than 5 minutes.

What NOT to do

The CDC says that knowing what not to do is just as important for keeping someone safe when they are having a seizure. According to the CDC:

• Do not hold the person down or try to stop their movements.
• Do not put anything in the person’s mouth. This can injure their teeth or jaw. Know that a person having a seizure cannot swallow his or her tongue.
• Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure.
• Do not offer the person water or food until they are fully alert.

When to call 911

Seizures do not usually require emergency medical attention. Only call 911 if one or more of these are true:

• The seizure lasts longer than 5 minutes.
• The person has another seizure soon after the first one.
• The person has difficulty breathing or waking after the seizure.
• The seizure happens in water.
• The person is injured, pregnant, or sick.
• The person has never had a seizure before.

What to do after someone has a seizure

“Seizures are unpredictable and often leave a person feeling a loss of control. Knowing what happened during a seizure and talking about it may help make the seizures less scary. You also can help someone get the help they may need to stay safe,” says Dr. Ian Goldsmith, Department of Neurology, Baystate Health. Some good advice:

Tell them what happened very simply and matter-of-factly.

The person may not remember, so write down what happened for them. They can then share this with their doctor to assist in their epilepsy care.

This information can help the person and his/her healthcare providers determine the type of seizures, whether treatment is working, and any need for changes.

More Information on seizure first aid and treatment

While everyone should know basic seizure first aid, consider more in-depth training if you know someone with epilepsy.

For more information go to:

• American Red Cross First Aid App: Download the free Red Cross app for instant access to step-by-step first aid advice, including advice about seizures and epilepsy.
• Epilepsy Foundation Seizure First Aid and Safety: Get seizure first aid certified.
• Epilepsy Foundation Seizure First Aid Courses: Learn more about how to respond to seizures safely.

Baystate Medical Center is the only hospital in western Massachusetts that specializes in diagnosing and treating epilepsy and seizure disorders. Learn more about Baystate Health’s advanced care for seizure disorders.