Seizure first aid

Overview

A seizure is a sudden burst of electrical activity in the brain that can cause changes in movement, behavior, or awareness. Seizure first aid is the immediate care you give to someone who is having a seizure. Your goal is to keep them safe until the seizure stops on its own.

Yes, about 1 in 10 people will have at least one seizure in their lifetime.

Anyone can have a seizure, but they are more common in people with epilepsy, young children, and older adults.

Symptoms

Common symptoms

• Loss of consciousness
• Stiffening of the body (tonic phase)
• Jerking movements of arms and legs (clonic phase)
• Biting tongue or cheek
• Loss of bladder or bowel control
• Confusion or drowsiness after seizure

Symptoms in children

• May have staring spells (absence seizures)
• Brief jerking movements
• Sudden falls without warning
• Breathing changes or turning blue

Symptoms in older adults

• More often partial seizures (affecting only part of the body)
• Confusion or memory loss after seizure
• May be mistaken for fainting or stroke

Causes

Main causes

• Epilepsy (a brain condition that causes repeated seizures)
• High fever (febrile seizures in children)
• Head injury
• Brain infection (meningitis, encephalitis)
• Stroke or brain tumor
• Very low blood sugar, electrolyte imbalances
• Drug or alcohol withdrawal

Risk factors

• Family history of epilepsy
• Past head injury
• Stroke or other brain conditions
• Sleep deprivation
• Stress
• Alcohol or drug use

When to see a doctor

See a doctor urgently if:

• If it's the first seizure you've ever had
• If the seizure occurs in a person without known epilepsy
• After any seizure that required emergency care

Book a routine appointment if:

• If you have epilepsy and your seizures change in pattern or frequency
• If you experience side effects from seizure medication (but discuss with your doctor)

Diagnosis

A doctor will take a detailed history of the seizure, ask about symptoms, and may order tests to look at your brain's electrical activity and structure.

Tests that may be done

• Electroencephalogram (EEG) — records brain waves
• MRI or CT scan — looks for brain abnormalities
• Blood tests — check for infections or chemical imbalances

What to expect at your appointment

You will be referred to a neurologist, a doctor who specialises in the brain. Diagnosis may take time, and you may need to keep a diary of any future episodes.

Treatment

Treatment depends on the cause of the seizure and whether you have epilepsy. For a single seizure, you may not need treatment. For epilepsy, the main treatment is medication to prevent seizures. Sometimes surgery or other therapies are needed.

Self-care at home

• During a seizure: stay calm, time the seizure, protect the person from injury (clear hard objects, put something soft under their head), roll them onto their side after jerking stops so fluids can drain.
• Do not: hold the person down, put anything in their mouth, or give them water until fully awake.
• After the seizure: stay with them, talk calmly, let them rest. Seek medical advice if it's their first seizure.

Medical treatments

Medications called anti-seizure drugs are used to control epilepsy. They must be taken exactly as prescribed. If medications do not work, doctors may consider a special diet (ketogenic diet) or a vagus nerve stimulator (a device that sends electrical pulses to the brain). Surgery to remove the part of the brain causing seizures is an option for some people.

When is surgery considered?

Surgery may be considered if seizures come from one small area of the brain that can be safely removed without affecting important functions.

Living with this condition

For people with epilepsy, daily life involves taking medication regularly, getting enough sleep, avoiding triggers like stress or alcohol, and wearing a medical ID bracelet.

Lifestyle tips

• Always take your medication as prescribed – never suddenly stop.
• Avoid known triggers: missed sleep, flashing lights (for some), alcohol, and stress.
• Tell family, friends, and coworkers what to do if you have a seizure.
• Drive only if you have been seizure-free for the period required by your local laws.

Diet and exercise

A healthy, balanced diet supports overall brain health. Regular exercise is safe and beneficial for most people with epilepsy. Always talk to your doctor before starting a new exercise programme.

Mental health and emotional wellbeing

Living with seizures can be stressful and may affect your mood and confidence. Anxiety and depression are common. It's important to talk to your doctor if you feel this way – support and treatment are available.

Prevention

Many seizures cannot be prevented, but you can reduce the risk by managing triggers, taking medication as prescribed, getting enough sleep, and treating underlying conditions like fever or infection.

Complications

If left untreated

• Status epilepticus – a seizure that lasts more than 5 minutes, which is a medical emergency.
• Injury from falling or hitting objects during a seizure.
• Drowning if a seizure occurs in water.
• Sudden unexpected death in epilepsy (SUDEP) – a rare but serious risk.

Long-term outlook

With proper treatment and care, most people with epilepsy can live full, active lives. Many children outgrow their seizures. If you or a loved one has a seizure, getting the right medical advice and support makes a big difference.

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