epilepsy

What to do when someone has a seizure

first aid

These guidelines are particularly relevant for tonic clonic (convulsive) seizures (see page 8).Friday 10am . However you should always dial 999 for an ambulance if: • it is the person’s first seizure.A large print text only version of this leaflet is available from the Epilepsy Helpline on: (Monday .4pm) 01494 601 400 first aid Usually when a person has an epileptic seizure there is no need to call an ambulance. or • the seizure lasts for more than five minutes and you do not know how long their seizures usually last. • they have injured themselves badly. • they have trouble breathing after the seizure has stopped. . • the seizure lasts two minutes longer than is usual for them. • one seizure immediately follows another with no recovery in between.

move and feel. Are all epileptic seizures the same? There are many different kinds of epileptic seizure. How epilepsy affects one person can be different to how it affects someone else. The nerve cells do this by passing electrical signals to each other. If you don’t know about their epilepsy.What to do when someone has a seizure Knowing how to help someone during and after an epileptic seizure may help you. this leaflet gives you some general guidance on how you can help if they have a seizure. If you know the person. • Some people have more than one type of seizure. • Some people only have seizures when they are awake. Epileptic seizures The brain is made up of millions of nerve cells which control the way we think. In some people. these signals may suddenly be interrupted. How you can help the person may depend on the type of seizures they have. feel more confident if a seizure happens. they may have told you about their epilepsy and how you can help them if they have a seizure. and this can cause an epileptic seizure (sometimes called a ‘fit’ or ‘attack’). and them. 3 .

last a short time (a few seconds or minutes) and stop by themselves. Most seizures happen suddenly. What happens during the seizure depends on where in the brain the seizure happens and what this part of the brain does. but most people do not hurt themselves and do not usually need to go to hospital or see a doctor.  See NSE leaflet ‘epilepsy . 4 . and affects. (See inside front cover for details about when to call for an ambulance). without warning. just part of the brain. Types of epileptic seizures and what to do Epileptic seizures can be divided into two main types: partial seizures and generalised seizures. Some people have seizures when they are awake and when they are asleep. Nocturnal seizures happen when the person is sleeping. only that they happen when the person is asleep.seizures’ for more information about seizure types. Seizures can vary from one person to another and how people are affected and how they recover after seizures also varies. Partial seizures In partial seizures the seizure starts in.• • • • Some people have nocturnal seizures. Injuries can happen during a seizure. The name does not explain what type of seizures they are.

Afterwards. SPS can feel unsettling so giving gentle reassurance may be helpful. an unusual smell or taste. You might notice them wandering around or behaving strangely and they may not know what they are doing. Complex partial seizures A complex partial seizure (CPS) affects a bigger part of the brain than a SPS. or a sudden intense feeling of fear or joy. fiddle with their clothes or make chewing movements with their mouth. A SPS could be twitching of one limb or part of a limb. or they might be confused for some time. They may pick objects up for no reason. 5 . What to do during the seizure: • do not restrain them as this may upset or confuse them.Simple partial seizures In a simple partial seizure (SPS) the person is conscious (awake) and aware of what is happening to them. they may need to sleep. a strange feeling such as a ‘rising’ sensation in the stomach or ‘pins and needles’ in part of the body. In a CPS the person’s consciousness is affected and they may be confused. What to do during the seizure: • although the person is awake and aware. CPS may last from a few seconds to a few minutes.

When this happens the person becomes unconscious and will usually have a tonic clonic seizure. and • stay with them until they have recovered. Some people recover quite quickly after their seizures. This is called a secondarily generalised seizure because it starts as a partial seizure and then becomes generalised. Secondarily generalised seizures For some people SPS and CPS develop into a generalised seizure (see below). Some people call their partial seizure an ‘aura’ or ‘warning’ because it warns them that a generalised seizure may follow.• • gently guide them away from dangerous situations (such as walking into the road). and respond in an upset or aggressive way. and can safely return to what they were doing before the seizure. They may be confused. They may mistake your help for being hostile. 6 . • they may be confused and not fully aware of their surroundings so it may help to remind them where they are. After the seizure stops: • they may feel tired and need to sleep. others may take longer to feel normal again. so if you speak loudly or act forcefully this may confuse them more. and speak quietly and calmly so that they are not startled.

For example. 7 . if they are walking they may continue to walk. If they are standing they often fall backwards and may injure the back of their head. usually a few seconds. but will not be aware of what they are doing during the absence. If they are standing they often fall forwards and may injure their face or head. Generalised seizures Generalised seizures affect all of the brain at once. Tonic and atonic seizures In a tonic seizure the person’s muscles suddenly become stiff. What to do during the seizure: • stay with them. gently guide them away from any danger. they may need help to make themselves safe before the generalised seizure starts. They may look blank and not respond to what is happening around them. Absences (sometimes called petit mal) During an absence a person becomes unconscious for a short amount of time. The person becomes unconscious and afterwards will not remember what happened during the seizure.What to do during the seizure: • if they are aware of an aura. and if necessary. In an atonic seizure (also called a drop attack) the person’s muscles suddenly relax. and they become floppy.

If they have been injured. Myoclonic seizures Myoclonic seizures involve the jerking of a limb or part of a limb. the person recovers and their breathing goes back to normal. They are brief and can happen in clusters with many happening close together in time. 8 . They often happen shortly after waking up from sleep. especially around their mouth. They may also bite their tongue. During the seizure their breathing might be affected and they may go pale or blue. Tonic clonic (convulsive) seizures (sometimes called grand mal seizures) When a person has a tonic clonic seizure they usually fall to the ground and make shaking or jerking movements. What to do after the seizure: • as they recover they may need reassurance. they may need medical help. these seizures are not usually a medical emergency. Usually. People usually recover quickly. Although this can be frightening to see. once the jerking has stopped.Tonic and atonic seizures tend to be very brief and happen without warning. there is nothing that needs to be done to help the person other than making sure they haven’t hurt themselves. As they are so brief.

allow the seizure to happen. or cup their head in your hands.there is no danger of them swallowing their tongue during the seizure.What to do during the seizure: • try to stay calm. • do not restrain them. to stop their head hitting the ground.see page 11). for example. away from the person if there is a risk of injury. • move objects. • do not put anything in their mouth . • note the time to check how long the seizure is going on (because there may be a risk of status . See photo 1. Only move the person if they are in a dangerous place. photo 1 photo 2 9 . at the top of stairs or in the road. such as furniture. • put something soft (like a jacket or cushion) under their head. and • try to stop other people from crowding around. See photo 2.

10 . and • stay with them. If they have wet themselves. Some people recover quickly after these seizures but more often the person will be very tired. Usually when a person has a tonic clonic seizure there is no need to call for an ambulance. seizures do not stop. usually last. When a seizure goes on for 30 • the seizure last for more than five minutes minutes or more it is called status epilepticus. and usually • one seizure immediately follows another with stop by themselves. until they have fully recovered. Status epilepticus • they have trouble breathing after the seizure Most people’s seizures last the same length has stopped. • try to minimise any embarrassment. and you do not know how long their seizures or ‘status’ for short. giving reassurance. or one seizure follows • the seizure lasts two minutes longer than another without the person recovering in usual for them. may want to sleep and may not feel ‘back to normal’ for several hours or sometimes days. deal with this as privately as possible. • they have injured themselves badly. However. • wipe away any spit and if their breathing is difficult check their mouth to see that nothing is blocking their airway. sometimes no recovery in between. However you should always dial 999 for an ambulance if: • it is their first seizure. like food. of time each time they happen.What to do when the jerking (convulsing) has stopped (recovery): • roll them on to their side into the recovery position (see page 15). or between.

When a seizure goes on for 30 minutes or more it is called status epilepticus. However. status in a tonic clonic (convulsive) seizure is a medical emergency.  See NSE leaflets ‘epilepsy – medication for adults’ or ‘epilepsy – medication for children’ for more information about medication for status.  See the information box on page 10 for when to call for an ambulance. Status can occur in any type of seizure and the person may need to see a doctor. and usually stop by themselves. It is important to call for an ambulance before the seizure goes on too long. However. Sometimes this is given rectally (into the person’s bottom). sometimes seizures do not stop. or one seizure follows another without the person recovering in between.Status epilepticus Most people’s seizures last the same length of time each time they happen. Carers will need training on how to give rectal diazepam and it is important to have a written protocol (plan) for each individual. for the carer to follow. or ‘status’ for short. Some people who go into status are prescribed a form of emergency (or rescue) medication called diazepam to stop their seizures. 11 . Do not wait until it has lasted 30 minutes before calling for help.

wander about or fiddle with their clothing? • Did their colour change (become pale or flushed) and if so. such as an odd smell or taste? • What made you notice the seizure (a noise. become noisy.were they excited. If you see someone having a seizure. hungry or unwell? • Did they have any warning that the seizure was going to happen? • Did they have any unusual sensations. did they fall or did their eyes roll)? • Did they appear to be ‘blank’ or stare into space? • Did they lose consciousness or were they confused? • Did they do anything unusual such as mumble. An ‘eyewitness description’ like this may help to diagnose and identify what type of seizures a person is having.How else can I help? Because people are often not fully aware during their seizures they might not know what happens to them. anxious or quiet? • Were there any triggers for the seizure – did they feel tired. it can be helpful to note the following things. • Where were they and what were they doing before the seizure? • Did you notice their mood change . where (face or lips)? • Did their breathing change (e. Other people who have seen the seizures can often provide useful information for the GP or neurologist. or look difficult)? 12 .g.

such as stress or tiredness? • Do they have a history of status? If so. • What types of seizures do they have? For example.  Contact NSE for a free seizure diary.• • • • • • • • Did any part of their body move. • Are their seizures usually triggered or ‘brought on’ by anything. 13 . complex partial seizures or absences. or go stiff or floppy? Did they wet themselves? Did they bite their tongue or cheek? How long did the seizure last? What were they like after the seizure? Did they need to sleep? How long was it before they were able to carry on as normal? Did you notice anything else? What do I need to know about someone’s epilepsy? There are some things it can be useful to know about someone’s epilepsy. jerk or twitch? Did they fall down. Although the length of seizures is different from person to person a seizure usually lasts the same length of time for each person. in a seizure diary. do they need emergency medication? (See page 11). • How often do they have seizures? Some people keep a note of when their seizures happen. • How long do their seizures normally last? Epileptic seizures usually stop by themselves. so you can help them if they have a seizure.

videos. See NSE’s recommended reading list: www. There are many books about epilepsy available to buy from booksellers and online.org.uk/readinglist See ‘NSE information’ leaflet for details of all NSE leaflets. such as an identity (ID) card or a bracelet or necklace.medication for children epilepsy .ID cards and medical jewellery’.• • How long does it take them to fully recover after a seizure? Some people recover quickly.seizures epilepsy .  Contact NSE for a free ID card or a copy of the NSE factsheet ‘epilepsy . Do they take anti-epileptic drugs? When do they usually take them? ID cards and medical jewellery Some people with epilepsy wear or carry something that says they have epilepsy.ID cards and medical jewellery Available online or from the Helpline. DVDs and books. Further Reading NSE information epilepsy .medication for adults epilepsy . If they have a seizure the information carried on the ID card or jewellery lets other people know what is happening and how to help.epilepsynse. 14 . others may be confused for a while.

• Keeping their hand against their cheek. Check that nothing is blocking their throat and that they are breathing. • Stay with them. with the palm facing upwards. . If you are not happy with how they are recovering. lift the knee furthest from you. and pull it upwards so that their leg is bent and their foot is flat on the floor.How to put someone into the recovery position 15 • Place the arm that is nearest you at a right angle to their body. Hold it there with your hand. call for an ambulance. • Make sure their airway is open by gently tilting their head back and lifting their chin. • Using your other hand. pull the bent knee towards you. This will roll them onto their side. Keep the knee bent and position this leg at a right angle to their body. • Lift their other arm across their body putting the back of their hand against their cheek nearest you.

Join NSE’s Associate Membership Scheme to receive regular information about epilepsy.epilepsynse. Please contact the Associate Membership Co-ordinator on 01494 601 402 for details. Registered Charity Number 206186.uk Epilepsy Helpline 01494 601 400 Monday . NSE cannot be held responsible for any actions taken as a result of using NSE information resources. For other information please write to Epilepsy Information Services National Society for Epilepsy Chesham Lane Chalfont St. This information is not intended to be a substitute for medical guidance from your own doctors.4pm Every effort is made to ensure that all our information is correct and up to date. Founded in 1892. Please note that some information may change after the date of printing.org.Friday 10am . Patron Her Majesty The Queen. © National Society for Epilepsy May 2007 . Peter Bucks SL9 0RJ Telephone 01494 601 300 Fax 01494 601 337 www.

Sign up to vote on this title
UsefulNot useful