questions to ask before seizure

Overview

A seizure is a sudden surge of electrical activity in the brain that affects how you feel or act. There are many types, and they can be different for each person. Preparing by asking the right questions can help you manage seizures better and feel more in control.

Yes. Seizures are quite common. About 1 in 100 people in the UK have epilepsy. Many more experience a seizure at some point in their life due to triggers like high fever or head injury.

Seizures can affect anyone, but they most often start in childhood or after age 60. However, they can begin at any age.

Symptoms

Common symptoms

• Convulsions (shaking or jerking movements)
• Staring spells (brief loss of awareness)
• Sudden confusion or trouble speaking
• Loss of consciousness or blacking out
• Strange feelings or sensations (like odd smells, tingling, or deja vu)

Symptoms in children

• Blank staring or daydreaming that is not normal
• Sudden falling without reason
• Rapid blinking or chewing motions without purpose
• Complaints of strange tastes or sounds

Symptoms in older adults

• Confusion that comes and goes
• Memory gaps or feeling 'off'
• Repetitive movements like pulling at clothes
• Fainting or unexplained falls

Causes

Main causes

• Epilepsy (a brain condition that causes repeated seizures)
• High fever (febrile seizures, especially in young children)
• Head injury or trauma to the brain
• Infection of the brain (like meningitis or encephalitis)
• Stroke or other blood vessel problems in the brain
• Low blood sugar or electrolyte imbalances

Risk factors

• Family history of epilepsy or seizures
• Previous brain injury or infection
• Stroke or dementia
• Alcohol or drug misuse
• Sleep deprivation or high stress

When to see a doctor

See a doctor urgently if:

• If you have a seizure for the first time at any age
• If a seizure lasts longer than 5 minutes
• If you have multiple seizures without regaining consciousness between them
• If you are injured during a seizure or have trouble breathing afterwards

Book a routine appointment if:

• If you suspect you or your child may have had a seizure but are not sure
• If you are already diagnosed and your seizures are not well controlled
• If you are experiencing side effects from your current treatment
• If you are planning to become pregnant or are already pregnant

Diagnosis

Your doctor will take a detailed history of what happened before, during, and after the seizure. They will also ask about your general health and any family history of seizures. You may be referred to a neurologist (brain specialist).

Tests that may be done

• EEG (electroencephalogram) – records the brain's electrical activity
• MRI or CT scan – to look at the structure of the brain
• Blood tests – to check for infections, blood sugar levels, or other health issues
• Sometimes a sleep-deprived EEG or ambulatory EEG (worn at home)

What to expect at your appointment

Diagnosis can take time, especially if seizures are infrequent. You may be asked to keep a diary of symptoms. The tests are painless, though the EEG can feel a bit strange. Your doctor will explain the results and discuss next steps with you.

Treatment

Treatment aims to stop or reduce seizures as much as possible. Most people start with medication, but there are other options if medication does not work well.

Self-care at home

• Keep a diary of your seizures – note when they happen, what you were doing, and how you felt before
• Avoid known triggers such as lack of sleep, stress, flashing lights (if you have photosensitive epilepsy), and alcohol
• Wear a medical alert bracelet that says you have seizures
• Make your home safer – put soft padding on sharp corners, use a shower seat, and never swim alone

Medical treatments

Anti-seizure medications are the main treatment. They are taken regularly to prevent seizures. If medications do not control seizures, other options include a special diet (ketogenic diet), a device called a vagus nerve stimulator (VNS) that sends electrical signals to the brain, or responsive neurostimulation. Always talk to your doctor about the best plan for you – never change medications without medical advice.

When is surgery considered?

For some people whose seizures start from a small, well-defined area of the brain, surgery to remove that area may be an option. This is considered when medications do not control seizures, and you are a suitable candidate. Your specialist will explain the risks and benefits.

Living with this condition

With proper treatment, most people can work, go to school, and enjoy social activities. You may need to follow driving rules – in the UK, you must tell the DVLA if you have seizures. Having a seizure action plan at home, school, or work can help others know what to do.

Lifestyle tips

• Get enough sleep – lack of sleep is a common trigger
• Manage stress with relaxation techniques like deep breathing or meditation
• Avoid alcohol and recreational drugs, as they can trigger seizures or interact with medication
• Take your medication exactly as prescribed – do not miss doses

Diet and exercise

A healthy diet and regular exercise are good for overall health. Some people with seizures find that a special diet (ketogenic or modified Atkins diet) helps, but this should only be done under medical supervision. Stay active but avoid high-risk activities like rock climbing or scuba diving unless you are well-controlled.

Mental health and emotional wellbeing

Living with seizures can be emotionally challenging. You may feel anxious about when the next seizure will happen, or depressed about the condition. It is important to talk about these feelings with your doctor. Counselling or support groups can also help.

Prevention

Not all seizures can be prevented, but you can reduce your risk by taking your medication as prescribed, avoiding known triggers, and maintaining a healthy lifestyle. If you have epilepsy, work with your doctor to find the best plan for you.

Complications

If left untreated

• Injury from falls or accidents during a seizure
• Status epilepticus (a seizure that does not stop) – a medical emergency
• Memory problems or difficulty learning over time
• Mood changes such as anxiety or depression
• Sudden unexpected death in epilepsy (SUDEP) – a rare but serious risk

Long-term outlook

Most people with seizures can lead full and active lives. With the right treatment, over half of people with epilepsy become seizure-free for long periods. Even if seizures continue, they can often be better managed. Advances in treatment continue to improve outcomes.

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