First Aid and Treatment

Recognizing a Seizure

Recognizing a seizure can help keep someone safe from injury caused by falls. The best way to know what it looks like when someone is about to have a seizure is by understanding their triggers and symptoms. Keep in mind, not everyone experiences the same things when they have a seizure and some may have no seizure indicators at all. 

Many report having one or more of these symptoms before having a seizure:

Awareness, Sensory, Emotional or Thought Changes:

  • Aura (a visual symptom often associated with flashing lights, blurred vision, some loss of sight, seeing things which are not actually there, as well as unpleasant smells or taste)

  • Prodrome (some people may experience feelings, sensations, or changes in behavior hours or days before a seizure)

  • Sudden fatigue

  • Headache/migraine

  • Anxiety/paranoia/panic

  • Confusion

Physical Changes:

  • Spacing (staring blankly)

  • Drooling or foaming at the mouth

  • Clenching of the teeth or jaw

  • Incontinence

  • Muscle spasms

  • Having trouble talking

Here are identifiable symptoms of someone actively having a seizure. Remember, there are several types of seizures and not every person has the same symptoms:

Awareness, Sensory, Emotional or Thought Changes:

  • Loss of awareness (often called “black out”)

  • Confused, feeling spacey

  • Periods of forgetfulness or memory lapses

  • Distracted, daydreaming

  • Loss of consciousness, unconscious, or “pass out”

  • Unable to hear

  • Sounds may be strange or different

  • Unusual smells (often bad smells like burning rubber)

  • Unusual tastes

  • Loss of vision or unable to see

  • Blurry vision

  • Flashing lights

  • Formed visual hallucinations (objects or things are seen that aren’t really there)

  • Numbness, tingling, or electric shock like feeling in body, arm or leg

  • Out of body sensations

  • Feeling detached

  • Déjà vu or jamais vu 

  • Body parts feels or looks different

  • Feeling of panic, fear, impending doom (intense feeling that something bad is going to happen)

  • Pleasant feelings

Physical Changes:

  • Difficulty talking (may stop talking, make nonsense or garbled sounds, keep talking or speech may not make sense)

  • Unable to swallow, drooling

  • Repeated blinking of eyes, eyes may move to one side or look upward, or staring

  • Lack of movement or muscle tone (unable to move, loss of tone in neck and head may drop forward, loss of muscle tone in body and person may slump or fall forward)

  • Tremors, twitching or jerking movements (may occur on one or both sides of face, arms, legs or whole body; may start in one area then spread to other areas or stay in one place)

  • Rigid or tense muscles (part of the body or whole body may feel very tight or tense and if standing, may fall “like a tree trunk”)

  • Repeated non-purposeful movements, called automatisms, involve the face, arms or legs, such as

    • lip smacking or chewing movements

    • repeated movements of hands, like wringing, playing with buttons or objects in hands, waving

    • dressing or undressing

    • walking or running

  • Repeated purposeful movements (person may continue activity that was going on before the seizure)

  • Convulsion (person loses consciousness, body becomes rigid or tense, then fast jerking movements occur)

  • Losing control of urine or stool unexpectedly

  • Sweating

  • Change in skin color (looks pale or flushed)

  • Pupils may dilate or appear larger than normal

  • Biting of tongue (from teeth clenching when muscles tighten)

  • Difficulty breathing

  • Heart racing

First Aid

Knowing what to expect, how to identify a seizure, and how to respond can save a life. While there are many different types of seizures, people who experience seizures may be confused, not aware of what is going on or unconscious. A person could get hurt during a seizure, a seizure could last too long, or the seizures could cluster. So, your role is important in their safety.​

Seizure first aid response includes:

  • Always stay with the person until the seizure is over.

  • Pay attention to how long the seizure lasts. If the person has a seizure lasting longer than five minutes or has a another seizure soon after the first one, seek medical attention immediately. 

  • Stay calm. Most seizures only last a few minutes.

  • Prevent injury by moving nearby objects out of the way.

  • Make the person as comfortable as possible.

  • Keep onlookers away.

  • Don’t hold the person down.

  • Don’t put anything in the person's mouth.

  • Don’t give water, pills or food by mouth unless the person is fully alert.

  • Make sure their breathing is okay.

  • Know when to call for emergency medical help.

  • Be sensitive and supportive, and ask others to do the same.

After Care

Awareness, Sensory, Emotional, or Thought Changes:

  • Slow to respond or not able to respond right away

  • Sleepy

  • Confused

  • Memory loss

  • Difficulty talking or writing

  • Feeling fuzzy, light headed, or dizzy

  • Feeling depressed, sad, upset

  • Scared

  • Anxious

  • Frustrated, embarrassed, ashamed

Physical Changes:

  • May have injuries, such as bruising, cuts, broken bones, or head injury if fell during seizure

  • May feel tired, exhausted, or sleep for minutes or hours

  • Headache or other pain

  • Nausea or upset stomach

  • Thirsty

  • General weakness or weak in one part or side of the body

  • Urge to go to the bathroom or lose control of bowel or bladder

                 FAQ
How can I tell if the person is okay after a seizure?

  • They are able to answer the four W’s: who, what, when, and where.

  • They can talk or communicate in some way.

  • You are able to wake them up if they fall asleep after a seizure.

  • They are breathing normally.

  • They are not injured.

 

If a person has had a seizure and is unable to perform anything on this list or is injured, seek medical attention immediately.

Should I tell the person who had a seizure what happened?
  • Right after a seizure most people aren’t ready to talk much about the seizures, but telling them what happened very simply and matter-of-factly can help.

  • If the person’s not remembering things well, write down what happened for them. They can then share this with their doctor, nurse, family, or others involved in their epilepsy care.

  • This information can help the person and his/her healthcare providers to determine the type of seizures, whether treatment is working, and the need for changes.

Treatment

Although there is no known cure for epilepsy, developments in treatment have made it possible for most people to achieve seizure control. The first treatment step is usually to find the right medicine or Anti-Epileptic Drug (AED). If seizures continue to happen, other treatments like devices, dietary therapies, or surgery can help control seizures.

Other forms of management of various symptoms include lifestyle changes such as diet, exercise, social interaction, sleep and stress management, and overall physical and mental wellness.

Watch this short video to learn more about treatment for seizure disorders: