long lasting seizure
Informed by recognized medical guidance
Overview
A long lasting seizure is a seizure that continues for more than 5 minutes, or when a person has multiple seizures without fully waking up in between. This is a medical emergency and requires immediate help.
Key facts
- A seizure lasting longer than 5 minutes is a medical emergency.
- Most seizures stop on their own within 1-2 minutes.
- Prompt treatment can prevent brain damage and other complications.
- Long lasting seizures are more common in people with epilepsy but can happen to anyone.
Long lasting seizures are not common. They happen in about 1 in 10 people who have epilepsy at some point. They can also occur in people without epilepsy due to other medical conditions.
It can affect people of any age, but it is more common in young children and older adults. People with epilepsy who miss their medication are at higher risk.
Symptoms
- Seizure lasting more than 5 minutes
- Repeated seizures without waking up between them
- First seizure that lasts more than 2 minutes
- Difficulty breathing or turning blue
- Seizure in water (pool, bath)
- Seizure causing injury or head trauma
- ⚠First seizure ever (call emergency for advice)
- ⚠Seizure that stops but person does not wake up fully after 10 minutes
- ⚠Seizure in a person with no known epilepsy
- ⚠Seizure in pregnancy
Common symptoms
- Seizure that lasts more than 5 minutes
- Repeated seizures without regaining consciousness in between
- Uncontrolled jerking or stiffening of the body
- Loss of awareness or unconsciousness
- Difficulty breathing or bluish skin color
Symptoms in children
- Seizure lasting more than 5 minutes
- Fever (febrile seizure) that becomes prolonged
- Unusual eye movements or staring
- Limpness or stiffness
- Breathing problems
Symptoms in older adults
- Confusion or drowsiness after a seizure that does not improve
- Sudden fall or collapse
- Twitching in one part of the body that spreads
- Loss of bladder or bowel control
- Changes in breathing pattern
Causes
Main causes
- Epilepsy (especially if medication is stopped or missed)
- High fever in children (febrile seizures that become prolonged)
- Head injury or brain trauma
- Brain infection (meningitis, encephalitis)
- Stroke or brain tumour
- Low blood sugar or electrolyte imbalances
- Alcohol or drug withdrawal
- Poisoning (e.g., from certain medications or toxins)
Risk factors
- Known epilepsy, especially if not well controlled
- Missing epilepsy medication doses
- Young age (especially under 5 years)
- Older age (over 60 years)
- Recent head injury
- Fever or infection
- Drinking too much alcohol or stopping suddenly
- Sleep deprivation or extreme stress
When to see a doctor
See a doctor urgently if:
- Any seizure that lasts more than 5 minutes or repeats without recovery
Book a routine appointment if:
- If you have had a first seizure that stopped on its own (seek medical evaluation within a few days)
- Follow up with your neurologist if you have epilepsy and your seizure pattern changes
- Discuss any side effects or concerns about seizure medications
Diagnosis
Diagnosis is made based on the description of the seizure, medical history, and tests after the seizure is brought under control.
Tests that may be done
- Electroencephalogram (EEG - records brain wave activity)
- Blood tests to check for infections, blood sugar, or electrolyte problems
- Brain imaging (CT scan or MRI) to look for injury, stroke, or other causes
- Lumbar puncture (spinal tap) if infection is suspected
- Neurological examination
What to expect at your appointment
In an emergency, doctors will first stabilise you and stop the seizure. Afterwards, they will take a detailed history and run tests to find the cause. You may be admitted to hospital for observation and further treatment. The team will discuss long-term management to prevent future prolonged seizures.
Treatment
A long lasting seizure is treated as an emergency. The goal is to stop the seizure as quickly as possible to prevent brain damage. Treatment includes rescue medicines given by paramedics or hospital staff, along with care for breathing and circulation.
Self-care at home
- If you have epilepsy, always have a clear emergency plan and share it with family and friends.
- Know your triggers (like missed medication, lack of sleep, alcohol) and avoid them.
- Wear a medical alert bracelet so others know you have seizures.
- Never put anything in someone's mouth during a seizure.
Medical treatments
First-line treatment is rescue medication, such as a benzodiazepine, given as a rectal gel, nasal spray, or injection. Emergency services may use intravenous medicines to stop the seizure. In hospital, longer-acting anti-seizure medicines may be given. Treatment is tailored to the person's age, weight, and medical history. Always follow your doctor's instructions regarding any rescue medication you may have at home.
When is surgery considered?
If seizures are caused by a specific brain lesion (like a tumour or abnormal blood vessel) and medicines do not control them, surgery may be considered. This is evaluated on a case-by-case basis by a specialist team.
Living with this condition
Living after a long lasting seizure involves recovery time — you may feel tired, confused, or have muscle soreness for hours or days. It is important to rest and follow up with your healthcare team. You may need to avoid driving for a period as advised by your doctor.
Lifestyle tips
- Take your epilepsy medication exactly as prescribed, never skip doses.
- Get enough sleep — lack of sleep is a common trigger.
- Avoid excessive alcohol and recreational drugs.
- Learn first aid for seizures so family and friends can help.
- Consider wearing a medical ID or carrying an emergency card.
Diet and exercise
A balanced diet helps overall health. For some people with epilepsy, a special diet (like ketogenic diet) may be recommended by a doctor. Regular exercise is safe for most people — but always check with your doctor. Avoid activities where a sudden seizure could cause injury, like swimming alone or climbing heights.
Mental health and emotional wellbeing
Having a long lasting seizure can be frightening and may cause anxiety, depression, or fear of future seizures. It is normal to feel worried. Talk to your healthcare provider about mental health support. Support groups and counselling can help.
Prevention
Not all long lasting seizures can be prevented, but many can be avoided by managing epilepsy carefully. Taking medication consistently, avoiding known triggers, and having a seizure action plan can lower the risk.
Vaccines
Some childhood vaccines prevent infections (like meningitis) that can cause seizures. Ensure vaccinations are up to date for your child.
Screening programmes
There is no routine screening test for the general population. People with recurrent seizures should be under specialist care to adjust treatment and monitor for complications.
Complications
If left untreated
- Brain damage from prolonged seizure activity
- Breathing difficulties or aspiration of saliva
- Injury from falls or accidents during seizure
- Memory problems and cognitive decline
- Sudden unexpected death in epilepsy (SUDEP)
Long-term outlook
With prompt emergency care and long-term management, most people recover well from a prolonged seizure. Many continue to lead full, active lives. Working closely with your healthcare team and following your treatment plan greatly reduces the chance of another emergency.
Find support
International organisations
Local organisations
- Your local epilepsy foundation or charity · Ask your healthcare provider for local resources
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 30, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.