seizure when to seek care

Overview

A seizure is a sudden burst of electrical activity in the brain. It can cause changes in movement, behavior, feeling, or awareness. Some seizures are dramatic, while others are so mild that only the person having them might notice.

Seizures are not rare. About 1 in 10 people will have at least one seizure at some point in their lifetime.

Seizures can affect people of all ages. They are sometimes more common in young children and older adults, but a seizure can happen to anyone.

Symptoms

Common symptoms

• Loss of awareness or consciousness
• Stiffening of the body
• Shaking or jerking of the arms and legs
• Staring and not responding
• Confusion or memory loss after the event
• Unusual sensations such as tingling, smells, or flashing lights

Symptoms in children

• Brief staring spells that look like daydreaming
• Subtle facial twitching
• Jerky movements of one arm or leg
• Sudden loss of muscle tone causing a fall
• Temporary unresponsiveness

Symptoms in older adults

• Sudden confusion or memory lapse
• Feeling of déjà vu or strange feelings
• Short episodes of staring or lip-smacking
• Falls without obvious cause
• Loss of urine or a brief period of unresponsiveness

Causes

Main causes

• Epilepsy (a condition where seizures happen without a treatable trigger)
• A very high fever (especially in children)
• Head injury
• Stroke or bleeding in the brain
• Brain infection (such as meningitis or encephalitis)
• Very low blood sugar
• Alcohol withdrawal or substance misuse
• Lack of sleep

Risk factors

• A family history of seizures or epilepsy
• A past brain injury or infection
• Age — seizures are more common in young children and older adults
• A history of stroke or heart problems
• Alcohol misuse or withdrawal
• Use of certain recreational substances

When to see a doctor

See a doctor urgently if:

• You or your child has a first-time seizure
• Seizures are happening more often or getting stronger
• A seizure lasts longer than usual for that person
• Seizures happen during or right after physical activity or exercise
• The person with epilepsy is planning to become pregnant
• A medical condition like diabetes or heart disease might be involved

Book a routine appointment if:

• You have recurring seizures and need a regular check-up
• You are prescribed medication for epilepsy and need monitoring
• You want advice on driving, work, or daily activities with seizures
• You need a review of your seizure action plan

Diagnosis

A doctor will ask about what happened before, during, and after the seizure. Because many people are not fully aware during a seizure, the doctor may also ask someone who saw it. They will also look for possible causes, such as low blood sugar or a recent injury.

Tests that may be done

• Electroencephalogram (EEG) — a safe test that measures electrical activity in the brain
• Blood tests — to check for infections, electrolyte problems, or other medical conditions
• Brain imaging (CT or MRI) — to look for structural changes in the brain
• Lumbar puncture (sometimes) — to check the fluid around the brain and spinal cord, if an infection is suspected

What to expect at your appointment

A doctor may refer you to a specialist in brain and nervous system conditions (a neurologist). You will probably be asked to describe the seizure in detail and may be given a diary to track future events.

Treatment

Treatment depends on the cause of the seizure and the type of seizures you have. The goal is to control seizures as much as possible and keep you safe. In many cases, medication can reduce or stop seizures.

Self-care at home

• During a seizure, keep the person safe: place them on the side, cushion their head, and remove nearby objects
• Do not hold the person down or put anything in their mouth
• Time the seizure with a watch or phone
• Stay with the person until it ends and they are fully awake
• Keep a seizure diary to notice patterns or triggers

Medical treatments

Treatments may include daily medicine that helps stop seizures, a device called a vagus nerve stimulator, or special diets such as a ketogenic diet in some cases. Always discuss any treatment with a specialist. Do not stop or change any prescribed treatment without talking to your doctor.

When is surgery considered?

For a small number of people with epilepsy, surgery may be offered if seizures start in one specific part of the brain and medicines do not control them. This is a personal decision made with a specialist team.

Living with this condition

If you have repeated seizures, building a routine can help you feel more in control. Take your prescribed treatment as directed, get enough sleep, and let close friends or family know how to help if you have a seizure. Wearing a medical alert bracelet can also be useful.

Lifestyle tips

• Get regular, good-quality sleep
• Avoid alcohol or recreational drug use that can trigger seizures
• Manage stress with relaxation techniques or mindfulness
• Take medication regularly if prescribed — never stop it suddenly
• Talk to your doctor before taking any new medicines or supplements

Diet and exercise

A balanced diet and regular physical activity are good for overall brain health. For some people with epilepsy, a doctor may recommend a special diet, like a ketogenic diet. Exercise is usually safe, but tell your trainer or exercise buddy about your condition and take precautions, such as not swimming alone.

Mental health and emotional wellbeing

Living with seizures can be stressful. Feelings of anxiety, depression, or worry about a next seizure are normal. These feelings are part of your health too. Talk to your healthcare team about how you're feeling — support and treatments are available.

Prevention

Not all seizures can be prevented, but you can lower your risk by avoiding head injuries (for example, wearing seatbelts and helmets), managing health conditions like diabetes or heart disease, sleeping enough, and following the treatment plan if you have epilepsy.

Complications

If left untreated

• Status epilepticus — a medical emergency where seizures go on too long
• Injuries from falls or accidents during a seizure
• Aspiration pneumonia — if food or fluid gets into the lungs during a seizure
• Memory problems or changes in thinking with frequent seizures
• Emotional problems like anxiety or depression
• In rare cases, sudden unexpected death in epilepsy (SUDEP)

Long-term outlook

The outlook for most people with seizures is positive, especially with the right care. Many people with epilepsy live full, active lives, and some children outgrow the condition. Treatment helps most people reduce seizures, and emergency care is available for dangerous situations. You are not alone — there are many ways to stay safe and well.

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