How to Help Someone During a Seizure

By Shaik Tanveer ulhaq 

Introduction

Seizures are often misrepresented in movies and television, where they appear dramatic and always require emergency intervention. In reality, seizures can present in different ways, and not all cases demand immediate hospitalization. Understanding the correct response can significantly improve patient safety and outcomes.

Understanding Seizures

A seizure is defined as a sudden surge of abnormal electrical activity in the brain, which can affect movement, sensation, behavior, or consciousness.

Seizures are broadly classified into two types:

• Focal seizures, which originate in a specific region of the brain

• Generalized seizures, which involve both hemispheres simultaneously 

These classifications are based on the area of the brain affected and the clinical manifestations observed.

Signs and Symptoms

Seizure manifestations vary widely and may include:

• Involuntary jerking or stiffening of muscles

• Loss of consciousness

• Drooling or teeth clenching

• Loss of bladder or bowel control

• Abnormal eye movements

• Sudden unresponsiveness or staring episodes (1)

Not all seizures involve convulsions; some may present as brief lapses in awareness.

Aura Phase

Certain individuals experience a warning phase known as an aura before the onset of a seizure. This may involve sensory disturbances, nausea, or headache.

Postictal Phase

Following a seizure, the individual may enter a recovery phase characterized by confusion, fatigue, or muscle soreness. This phase can last from a few minutes to several hours.

First Aid During a Seizure

When witnessing a seizure, the following measures should be taken:

• Remain calm and reassure the individual

• Ensure adequate space and prevent crowding

• Record the duration of the seizure

• Remove nearby hazardous objects

• Place a soft object under the head

• Check for medical identification

• Position the individual on their side if unconscious

• Stay with the person until full recovery

These steps help minimize injury and maintain airway safety.

Actions to Avoid

Certain actions must be strictly avoided:

• Do not insert objects into the mouth

• Do not attempt to restrain movements

• Do not move the individual unless necessary

• Do not leave the person unattended

Improper handling may lead to complications or injury.

When to Seek Emergency Help

Emergency medical services should be contacted under the following conditions:

• First-time seizure occurrence

• Duration exceeding five minutes

• Repeated seizures without recovery

• Associated injury

• Breathing difficulty post-seizure

• Prolonged unconsciousness

Not all seizures require hospitalization, but these situations indicate increased risk.

Post-Seizure Care

After the seizure subsides:

• Ensure the individual is breathing normally

• Allow adequate rest

• Avoid giving food or liquids until fully alert

Providing details such as seizure duration, symptoms, and preceding events can assist healthcare professionals in diagnosis and management.

Emotional support is equally important, as individuals may feel confused or embarrassed after the episode.

Common Misconceptions

“Seizures are rare”

Seizures are relatively common, with a significant proportion of individuals experiencing at least one episode in their lifetime.

“One seizure means epilepsy”

A single seizure does not confirm epilepsy. Diagnosis requires recurrent seizures under defined clinical conditions (2).

“A person can swallow their tongue”

This is a misconception. However, tongue biting may occur, and inserting objects into the mouth is unsafe.

“All seizures involve convulsions”

Seizure presentations vary, and not all involve visible motor activity.

“Hospitalization is always required”

Many seizures resolve spontaneously and only require supportive care.

“All seizures have the same cause”

Seizures can result from multiple factors, including metabolic disturbances, infections, high fever, neurological disorders, or substance use.

Seizure Preparedness

Individuals prone to seizures should develop a seizure action plan, which includes:

• Typical symptoms and triggers

• Duration of episodes

• Emergency contact information

• Instructions for bystanders

Sharing this plan and carrying medical identification can improve response during emergencies.

Conclusion

Seizures are complex neurological events that require informed and calm management. Proper first aid measures can prevent complications and ensure patient safety. Increasing awareness and addressing misconceptions can also reduce stigma associated with seizures and epilepsy.

References

1. Cleveland Clinic. Seizures [Internet]. Available from: https://my.clevelandclinic.org/health/diseases/22789-seizure

2. Mayo Clinic. Epilepsy: symptoms and causes [Internet]. Available from: https://my.clevelandclinic.org/health/diseases/22789-seizure

3. Epilepsy Society. First aid for seizures [Internet]. Available from: https://epilepsysociety.org.uk

Assessed and Endorsed by the MedReport Medical Review Board