Living with seizure

Overview

A seizure happens when there is a sudden burst of electrical activity in the brain. It can change how you move, feel, or act for a short time. Seizures can range from very mild (like a short stare) to dramatic (like shaking of the whole body).

Yes. About 1 in 10 people will have a seizure at some point in their life. It happens more often in young children and people over 65.

Seizures can happen to anyone, at any age. But some groups are more likely to have them, including babies and young children, older adults, and people with certain medical conditions such as epilepsy, stroke, or brain injury.

Symptoms

Common symptoms

• Brief staring spells or a sudden pause in activity
• Jerking or twitching of an arm, leg, or the face
• Stiffening of the body or shaking (convulsions)
• Confusion, poor awareness, or being unresponsive
• Strange feelings like a rising stomach sensation, strong emotions, or unusual smells
• Loss of consciousness or passing out

Symptoms in children

• Sudden staring or loss of attention in a child who is usually aware
• Facial twitching, eye blinking, or lip smacking
• Odd postures, like one hand or arm turning stiffly
• Loss of muscle tone, causing the child to flop or fall
• Breathing pauses that should always be checked urgently

Symptoms in older adults

• Confusion or memory problems that come and go
• Brief periods of staring or non-responsiveness
• Weakness or shaking in one part of the body, like an arm or leg
• Feelings of disorientation or déjà vu without a clear cause
• Falls without a clear reason may sometimes be related to a seizure

Causes

Main causes

• Epilepsy – a condition that causes repeated seizures
• High fever in children (febrile seizures)
• Head injury or brain damage
• Infections of the brain such as meningitis
• Stroke or bleeding in the brain
• Brain tumours
• Very low blood sugar, low sodium, or other metabolic changes
• Alcohol or drug misuse, or alcohol withdrawal

Risk factors

• A family history of seizures or epilepsy
• Age – most common in children and older adults
• Previous head injury or brain surgery
• A history of stroke or brain infection
• Sleep deprivation or severe stress
• Substance misuse (alcohol or recreational drugs)

When to see a doctor

See a doctor urgently if:

• First-ever seizure – call your local emergency number immediately
• Seizure that lasts longer than 5 minutes, or repeated seizures without recovery
• Seizure with difficulty breathing, chest pain, or a serious injury
• If you are pregnant or have a serious medical condition and have a seizure

Book a routine appointment if:

• You think you may have had a seizure, even if it was brief
• Your usual seizures seem different, more frequent, or your medicines are not working as well
• You have side effects from your anti-seizure medicines
• You are thinking about driving, working, or starting a family, and need advice

Diagnosis

A doctor will ask you to describe exactly what happened before, during, and after the episode. If someone witnessed it, their account is very helpful. The doctor may also ask about your medical history, any injuries, infections, or family members with seizures.

Tests that may be done

• EEG (electroencephalogram) – a test that records the electrical activity of the brain using small sensors on the scalp
• MRI (magnetic resonance imaging) – a scan that looks for any structural abnormalities in the brain, such as scars or growths
• Blood tests – to check for low blood sugar, electrolyte imbalance, infection, or any metabolic cause

What to expect at your appointment

You will often be referred to a neurologist, a doctor who specialises in the brain and nervous system. The tests are usually painless. After the tests, the doctor will talk to you about the likely cause and the next steps. Sometimes the cause remains unclear, but you can still receive support and treatment to reduce seizures.

Treatment

The most important part of treatment is finding out the cause and preventing future seizures. If you have epilepsy, treatment can usually control seizures very well. If a trigger was identified (such as fever, low sugar, or medication), treating that trigger may stop further seizures.

Self-care at home

• Take your medicines exactly as prescribed, even if you feel well
• Keep a regular sleep routine and avoid skipping meals
• Keep a seizure diary to recognise patterns and triggers
• Tell close friends, family, or colleagues how to help during a seizure
• Avoid activities that could be dangerous if a seizure happens until you discuss them with your doctor

Medical treatments

Medicines called anti-seizure drugs (anticonvulsants) are the main treatment. They do not cure the condition, but they help stop seizures in most people. The choice of medicine depends on the type of seizure and your situation. Other treatments include vagus nerve stimulation or responsive neurostimulation, which are devices that help control seizures. These are all prescribed and managed by a specialist team. Always follow your doctor's advice about medication.

When is surgery considered?

If medicines do not control your seizures, and doctors can identify a small area of the brain that is causing them, brain surgery may be possible. This surgery is called epilepsy surgery and is considered carefully and individually.

Living with this condition

Living with seizures involves learning what is safe and normal for you. You can still study, work, and enjoy hobbies. It may help to build a routine, plan around your seizure patterns, and make sure people around you know what to do.

Lifestyle tips

• Aim for regular, stable sleep – lack of sleep is a common trigger
• Find healthy ways to manage stress, such as breathing exercises or gentle activity
• Limit or avoid alcohol, especially heavy drinking; alcohol can make seizures more likely
• Be cautious with screens, rowing lights, or other flashing patterns if they affect you

Diet and exercise

A balanced diet and regular physical activity are good for overall health and may help your seizure control. In some specific types of epilepsy, a special diet (like a high-fat, low-carb diet) can help, but it should only be followed with the guidance of your healthcare team and a dietitian.

Mental health and emotional wellbeing

It is understandable to feel anxious, low, or worried about when a seizure may happen. You may also worry about relationships, driving, or work. Talking to a counsellor, doctor, or a loved one can help. If your mood is low most of the time, ask your healthcare provider about further support.

Prevention

Many causes of seizures cannot be prevented, but you can lower your risk of some triggers. For example, wear a seatbelt and a helmet where appropriate to avoid head injury. Manage health conditions like diabetes or high blood pressure, and avoid recreational drugs and heavy alcohol use. If you have epilepsy, adhering to your treatment plan is the best way to prevent seizures.

Vaccines

Some infections that can cause seizures, such as meningitis, can be prevented with vaccination. Staying up to date on recommended vaccines is a sensible step for you and your children.

Screening programmes

There is no general screening test for seizures in the general population. For people at higher risk, such as after a brain injury or with certain inherited conditions, a doctor may arrange an EEG or other tests to check for changes.

Complications

If left untreated

• Injury from a fall, hitting an object, or having a seizure near traffic or water
• Status epilepticus – a very long seizure that does not stop, where breathing or brain function can be affected
• Repeated seizures that affect memory, learning, or daily life
• Increased risk of accidents, such as drowning or burns, if you are not supervised

Long-term outlook

For most people, seizures can be controlled with medication and lifestyle changes. Many people with epilepsy become free of seizures for long periods. Even when a cause is not found, the outlook is often good. With support and the right care, most people can do the things that matter to them.

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