What to do if someone has a seizure

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Seizures are caused by abnormal electrical discharge, or misfiring, from neurons in the brain. Having a seizure is more of a symptom than a diagnosis; they can be caused by many underlying conditions, including high fever, low blood sugar or alcohol/drug withdrawal. A patient will be diagnosed with epilepsy if the cause of two or more seizures is unknown.

Seizures can be treated in various ways, including anti-seizure drugs, diet therapy (e.g., ketogenic diet or Atkins diet) and neurostimulation devices. The majority of patients can control their condition with these treatments, but about 30% require further surgery evaluation.

How to identify a seizure

Not every seizure looks like what you might see on TV. Depending on where the seizure started in the brain, the patient can experience different symptoms, some of which may even be difficult to notice.

In some types of seizure, the patient can maintain complete awareness and may experience abnormal sensation. Alternately, the patient may look confused, stare off into space, or have trouble understanding or following commands. These seizures can be challenging to detect, but often patients will notice that they’re losing time or are unusually tired.

A grand mal seizure, which involves loss of consciousness and convulsions, is more obvious to identify but also more dangerous for the patient. This kind of seizure comes with a higher risk of physical injury due to falling when losing consciousness or hitting something while convulsing. It can also stop the heart or block airways.

What to do if someone has a seizure

There are five easy steps:

  1. Remain calm and start timing the seizure; stay with the patient until the seizure resolves completely.
  2. Turn the patient on their side if they aren’t awake and aware.
  3. Don’t put anything in the patient’s mouth or restrain them.
  4. Keep the patient safe and move any potentially harmful objects away from them.
  5. Loosen any tight clothes around their neck.

Call 911 if the seizure doesn’t stop after five minutes or if the patient has trouble breathing, has acquired a physical injury or hasn’t returned to their usual state after the seizure has subsided.

Per Ohio law, people having uncontrolled seizures shouldn’t drive until cleared by a neurologist. If you have a seizure while driving, pull over immediately and call for help.

How can I learn more?

More information about seizures and epilepsy can be found at www.epilepsy.com. If you need to find a specialist, your primary care provider can guide you to find the specialist in your area. Additionally, the American Academy of Neurology and the American Epilepsy Society provide listings of neurologists and epilepsy specialists.

Jaysingh Singh is a neurologist at The Ohio State University Wexner Medical Center.