What to Do if Someone Has a Seizure?

A seizure can be a frightening experience to witness, especially if it happens unexpectedly. During a seizure, a person may experience changes in awareness, movement, behaviour, or sensation, and the episode can vary from mild and brief to more noticeable and dramatic. Knowing how to respond calmly and correctly is important, as appropriate first aid can help prevent injury and ensure the person’s safety until the seizure passes. In this blog, we will explain what happens during a seizure, the steps to take when someone is having one, what to avoid, and when emergency medical attention is needed.

What Happens During a Seizure?

A seizure occurs when there is a sudden burst of abnormal electrical activity in the brain. This temporary disruption interferes with the brain’s normal functioning and can affect different parts of the body depending on where the electrical activity begins and how far it spreads.

Because different areas of the brain control different functions, seizures can present in various ways. Some people may stare blankly, become briefly confused, or make repetitive movements, while others may lose consciousness and experience muscle stiffening or rhythmic jerking movements. The signs and symptoms can vary significantly from one person to another.

Most seizures are short-lived and typically follow three stages: a sudden onset, an active seizure phase, and a recovery period during which the person gradually regains normal awareness and function. Understanding these changes can help bystanders recognise a seizure and respond appropriately.

Common Causes of Seizures

Seizures can occur due to a wide range of underlying factors. Some causes are temporary and reversible, while others may be linked to an ongoing neurological condition. The causes of seizures can be grouped into the following categories:

• Neurological Conditions: Epilepsy is the most common long-term neurological condition associated with recurrent seizures, where abnormal electrical activity in the brain or an underlying structural lesion in the brain leads to repeated episodes
• Acute Medical Triggers: Seizures may occur suddenly due to short-term medical conditions such as high fever in children (febrile seizures), head injury affecting brain function, or infections like meningitis or encephalitis.
• Metabolic and Bodily Imbalances: Seizures can develop when the body’s normal chemical balance is disrupted, such as low blood sugar (hypoglycaemia) or abnormal electrolyte levels like sodium imbalance.
• Lifestyle Triggers: Certain lifestyle factors, such as severe sleep deprivation, high stress levels, or withdrawal from alcohol or other substances, can temporarily increase the risk of seizures in some individuals.
• Unknown Causes: Occasionally, seizures have no clear trigger, and no underlying cause is identified even after evaluation.

Common Symptoms of a Seizure

Seizures can present in different ways depending on the area of the brain affected and may vary in intensity and duration. Common seizure symptoms include:

• Loss of Awareness or Consciousness: During a seizure, a person may suddenly stop responding and appear unaware of their surroundings. This can look like a blank stare, and the person may not react when spoken to or touched.
• Changes in Body Movement: The body may become stiff, followed by uncontrolled jerking movements of the arms and legs. In some cases, the person may suddenly lose balance and fall to the ground.
• Breathing and Facial Changes: Breathing may become irregular or briefly pause during the episode. Some individuals may also experience drooling or frothing at the mouth, along with subtle changes in facial expression or eye movements.
• Behavioural or Sensory Changes: Some seizures may present as brief staring spells where the person seems “absent” or disconnected. They may also appear confused or disoriented during or after the episode. In certain cases, unusual sensations such as tingling or visual disturbances may occur.

Types of Seizures

Seizures are usually classified based on where they begin in the brain. Understanding the main types can help with awareness, but during an actual episode, the focus should always be on safety rather than identification.

1. Focal Onset Seizures

These seizures start in one specific area of the brain. The symptoms depend on the part of the brain involved and may affect movement, sensation or awareness on one side of the body. In some cases, the seizure can spread and involve both sides of the brain.

2. Generalised Onset Seizures

These seizures involve both sides of the brain from the beginning. They often affect awareness and may cause sudden changes in movement or behaviour.

What to Do During a Seizure 

Seeing someone have a seizure can be frightening, but the focus should be on staying calm and keeping the person safe. Most seizures stop on their own within a few minutes, so your main role is to prevent injury and support them until the episode ends.

Stay Calm and Ensure Safety

You should remain calm and stay with the person throughout the seizure. Quickly check the surroundings and remove any sharp or hard objects nearby that could cause injury. Only move the person if they are in immediate danger, otherwise focus on making the area safe.

Position the Person Safely

Once it is safe, gently lower the person to the ground to prevent a fall. Turn them onto their side (recovery position) to help keep the airway clear and reduce the risk of choking. This position also supports easier breathing.

Protect the Head

Place something soft under the person’s head, such as a folded cloth, jacket or cushion. This helps reduce the risk of injury during involuntary movements. Do not restrain the head or body.

Loosen Tight Clothing

Loosen any tight clothing around the neck, collar or waist. This can help improve comfort and support easier breathing during the episode.

Time the Seizure

Note the time when the seizure starts and how long it lasts. This information is important for healthcare professionals and helps determine whether emergency care is needed.

Stay With the Person Until Recovery

Remain with the person until the seizure stops and they regain awareness. Speak calmly and reassure them, as confusion, tiredness or disorientation is common afterwards. Continue to monitor breathing and ensure they are safe during recovery.

What Not to Do During a Seizure

While knowing what to do is crucial, it is equally important to understand what should be avoided. Certain actions, although well-intentioned, can increase the risk of injury or complications during a seizure. Here is a list of things that need to be avoided during a seizure:

• Do Not Place Anything in the Mouth: Contrary to common belief, do not put anything in the person’s mouth, including fingers, spoons or other objects. A person cannot swallow their tongue during a seizure, and inserting objects can cause choking or dental injury.
• Do Not Restrain Movements: Trying to hold the person down can lead to muscle or bone injuries. It is safer to allow the seizure to run its course while ensuring the surrounding area is safe.
• Do Not Give Food, Water, or Medication: The person may not be fully conscious and could choke if anything is given during or immediately after the seizure.
• Do Not Attempt to Shake or Forcibly Revive the Person: Shaking, shouting or trying to wake them will not stop the seizure and may cause unnecessary distress or injury.
• Do Not Perform CPR Unless Necessary: CPR should only be started if the person is not breathing normally after the seizure has ended and remains unresponsive.

When is it a Medical Emergency?

Every seizure is a medical emergency; but most seizures stop on their own without requiring urgent medical intervention. However, there are certain situations where immediate medical attention is necessary to ensure the person’s safety and prevent complications. Seizure emergency care is required in the following situations:

• A seizure lasting longer than five minutes increases the risk of complications and requires urgent medical care.
• Repeated seizures without recovery of consciousness require emergency help if another seizure occurs before the person regains awareness.
• First-time seizure occurrence should always be medically evaluated to identify the underlying cause.
• Injury sustained during the episode requires prompt assessment for any head injury or significant physical trauma.
• Persistent breathing difficulty after a seizure requires immediate medical attention if normal breathing does not resume or remains laboured.
• Occurrence during pregnancy or in individuals with chronic illness requires prompt medical evaluation due to a higher risk of complications.

What to Do After the Seizure –

After a seizure stops, the person should visit a doctor, as they may not immediately return to normal awareness. This recovery phase is important, and supportive care can help ensure their safety. Post-seizure care includes:

• Keep The Person in a Safe Position: If they are still drowsy, gently turn them onto their side to maintain an open airway and reduce the risk of choking.
• Check Breathing and Responsiveness: Ensure they are breathing normally and gradually becoming more alert.
• Offer Reassurance: Speak calmly, as the person may feel confused or embarrassed after the episode.
• Allow Time to Rest: Fatigue, headache or weakness are common after a seizure, so encourage rest in a quiet environment.
• Avoid Giving Food or Drink Immediately: Wait until the person is fully awake and able to swallow safely.
• Stay With Them Until Fully Recovered: Remain present until they are completely alert and able to communicate normally.

Special Situations

Seizures can occur in different settings and age groups, and the response may need slight adjustments depending on the situation. While the basic first aid principles remain the same, certain scenarios require additional awareness and care.

Seizures in Children

Seizures in children are often linked to high fever and are known as febrile seizures. These can be frightening to witness, but they are usually brief and do not cause long-term harm.

Monitor the child’s fever closely and manage it appropriately as advised by a healthcare professional. Medical attention should be sought if the seizure is prolonged, if it is the child’s first episode, or if there are concerns about recovery or underlying illness.

Seizures in Public Places

When a seizure occurs in a public setting, the priority is to ensure immediate safety by clearing space around the person and preventing injury. Bystanders should be calmly guided to maintain distance so the person has enough room to move safely.

If the seizure is prolonged or if the person does not recover as expected, emergency services should be contacted without delay.

Individuals with Known Epilepsy

People diagnosed with epilepsy often follow a personalised care plan provided by their healthcare team. Prescribed medication must be taken regularly, as missed doses can increase the risk of seizures.

Some individuals may also carry emergency instructions or medical identification. Following these guidelines during a seizure can help ensure appropriate and timely care.

Can Seizures Be Prevented?

Not all seizures can be prevented; however, for many individuals, understanding and managing triggers can help reduce the likelihood of episodes. Common trigger management includes:

• Adequate Sleep: Maintaining a regular sleep pattern helps reduce the risk of seizures triggered by fatigue or sleep deprivation.
• Stress Management: High stress levels can act as a trigger in some individuals, so managing stress through relaxation techniques or lifestyle changes may be beneficial.
• Regular Medication Adherence Where Prescribed: Taking prescribed anti-seizure medication consistently is essential for individuals diagnosed with epilepsy.
• Avoiding Known Personal Triggers: Some people may have specific triggers such as flashing lights, alcohol or missed meals, which should be identified and avoided wherever possible.

Importance of Medical Evaluation

Even a single seizure should be clinically assessed, as it may indicate an underlying neurological or medical condition. Medical evaluation is important because it helps healthcare professionals:

• Identify the Underlying Cause: Determine whether the seizure is linked to epilepsy, infection, injury or other medical conditions for which detailed neurological workup is needed in the form of MRI, and various blood tests.
• Assess Overall Health Status: Review medical history, symptoms and possible triggers associated with the episode
• Guide Further Investigation If Needed: Decide whether tests such as EEG or brain imaging are required for clarification
• Ensure Accurate Diagnosis: Differentiate between seizure types and rule out other conditions that may mimic seizures
• Support Long-Term Care Planning: Help determine whether ongoing treatment, monitoring or lifestyle changes are necessary

Consult a Specialist at Graphic Era Hospital

A seizure should always be taken seriously, whether it is a one-time event or a sign of an underlying health condition. Professional evaluation is important to ensure an accurate diagnosis and an appropriate care plan based on individual needs. If you or a loved one is experiencing recurrent or unexplained seizures, it is advisable to consult a neurologist at Graphic Era Hospital. Our specialists can help evaluate the possible cause and may recommend investigations such as CT scans or MRI, if required, to support diagnosis and guide management. To book an appointment, call 1800 889 7351.