Epilepsy rescue medicine plan

Overview

A rescue medicine plan is a written plan created with your doctor that tells you exactly what to do if you have a seizure that does not stop on its own. It includes the type of fast-acting medication to use and when to call for emergency help.

Epilepsy itself is common – about 1 in 100 people have it. Many of those with epilepsy have a rescue medicine plan to keep them safe during a seizure.

It affects people of all ages, from children to older adults, who have epilepsy and are at risk for prolonged or repeated seizures.

Symptoms

Common symptoms

• Sudden stiffening of the body (tonic phase)
• Jerking or twitching movements (clonic phase)
• Loss of awareness or staring spells
• Unusual sensations like tingling, strange smells, or déjà vu before a seizure
• Confusion or tiredness after a seizure

Symptoms in children

• Sudden staring or blinking
• Blank expressions that do not respond to you
• Repetitive movements like chewing or hand rubbing
• Falling down without warning

Symptoms in older adults

• Brief confusion that may be mistaken for forgetfulness
• Sudden drop attacks where they fall without jerking
• Unusual sensations or dizziness that come and go

Causes

Main causes

• Epilepsy itself is caused by sudden bursts of electrical activity in the brain.
• Brain injuries from a head injury, stroke, or infection.
• Genetic conditions that make the brain more likely to have seizures.
• Brain tumors or other structural issues in the brain.

Risk factors

• Having uncontrolled epilepsy despite regular medication.
• Missing doses of daily seizure medicine.
• Lack of sleep, high stress, or drinking too much alcohol.
• Having a fever or illness that triggers seizures.
• Frequent changes in seizure patterns.

When to see a doctor

See a doctor urgently if:

• If you or a loved one has a seizure for the first time.
• If a seizure lasts longer than 5 minutes.
• If you run out of rescue medicine and do not have a plan.
• If the rescue medicine does not work as expected.

Book a routine appointment if:

• To create or review your rescue medicine plan with your neurologist or specialist nurse.
• If your seizures change in type, frequency, or length.
• To update the plan after any change in your daily seizure medicine.
• If you are planning to travel or change your routine.

Diagnosis

A rescue medicine plan is not a diagnosis – it is based on your existing epilepsy diagnosis. Your doctor will review your seizure history and current medicines to decide if a rescue plan is right for you.

Tests that may be done

• Review of seizure diary and any video recordings of seizures.
• Electroencephalogram (EEG) to see brain wave patterns.
• Brain imaging (MRI or CT) if needed to check for changes in the brain.

What to expect at your appointment

You will meet with a doctor or epilepsy nurse specialist. They will ask about your seizures, daily medicine, and any past emergencies. Together you will write a clear, one-page plan that includes when to give rescue medicine, how to give it, and when to call for an ambulance. You will get a copy to keep and give to family or carers.

Treatment

A rescue medicine plan is a safety net, not a replacement for daily seizure medication. The plan helps you act quickly when a seizure does not stop.

Self-care at home

• Keep your rescue medicine in a safe, easy-to-reach place and check the expiry date regularly.
• Tell close family, friends, and co-workers about your plan and how to help.
• Wear a medical alert bracelet or ID that says you have epilepsy and a rescue plan.
• Learn to recognize your own warning signs or aura before a seizure.
• Stay calm and follow the steps in your plan – do not put anything in the person’s mouth.

Medical treatments

Rescue medicines are fast-acting treatments, usually given as a gel or spray that goes into the nose or a cream that goes into the rectum. They work to quickly stop a seizure. Your doctor will prescribe the type and dose that is best for you and teach you or your carer how to use it. Always use exactly as instructed.

When is surgery considered?

Surgery is not part of a rescue medicine plan. However, some people with epilepsy may have brain surgery to reduce or stop seizures. Your doctor will discuss this if it is an option for you.

Living with this condition

A rescue medicine plan helps you feel more in control. You can go to school, work, and enjoy activities knowing that if a seizure happens, there is a clear plan. Always carry your rescue medicine and plan with you if your doctor advises.

Lifestyle tips

• Take your daily seizure medicine exactly as prescribed.
• Get enough sleep – lack of sleep is a common seizure trigger.
• Manage stress with relaxation activities like walking, meditation, or talking to friends.
• Avoid activities that could be dangerous if a seizure occurs, such as swimming alone or climbing ladders, unless you have safety measures in place.

Diet and exercise

Healthy eating may help overall health. Some people find that a special diet (like the ketogenic diet) can reduce seizures, but only do this under medical supervision. Most types of exercise are safe – just take precautions and let your exercise partner know about your rescue plan.

Mental health and emotional wellbeing

Living with epilepsy can be stressful and worrying. You may feel anxious about when the next seizure will happen. It is normal to feel frustrated or sad at times. A rescue medicine plan can reduce some of that worry, but if you feel very anxious or depressed, talk to your doctor. There are counsellors and support groups that understand.

Prevention

A rescue medicine plan does not prevent epilepsy itself, but it can prevent a seizure from becoming a medical emergency. Taking daily seizure medicine as prescribed and avoiding known triggers (like lack of sleep or stress) are the best ways to reduce seizures.

Screening programmes

There is no routine screening test for epilepsy. If you have already been diagnosed, your doctor will monitor your condition and adjust your plan over time.

Complications

If left untreated

• A long seizure (status epilepticus) that can cause brain damage or be life-threatening.
• Injury from falling during a seizure.
• Biting the tongue or other mouth injury.
• Choking or breathing difficulties.
• Sudden unexpected death in epilepsy (SUDEP) – very rare, but having a rescue plan reduces the risk.

Long-term outlook

With a good rescue medicine plan and daily treatment, most people with epilepsy live full and active lives. Seizures can often be controlled or reduced. The plan gives you and your loved ones confidence to handle emergencies calmly. Many people with epilepsy are able to work, drive (once seizure-free for a required time), and enjoy family life.

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