Are all epileptic seizures the same?
There are many different kinds of epileptic seizure and the action required during and after a seizure will depend on the seizure type. Some people may experience more than one kind of seizure. Some people only experience seizures when they are asleep. The following procedures also apply to sleep seizures.
What do I need to know about somebody's epilepsy?
Knowing the answers to the following questions will enable you to help someone during a seizure and to pass on the relevant information to medical personnel if necessary.
- What types of seizures does the person have?
- How long do their seizures normally last? (Epileptic seizures usually stop of their own accord and last a similar length of time on each occasion.)
- Does the person have a history of status epilepticus? When a seizure does not stop naturally, or one seizure follows another with no recovery in between, it is known as status epilepticus and medical attention will be required.
- How long does it take for the person to fully recover following a seizure?
- Does the person need to sleep afterwards or are they confused?Some people may appear to be fully recovered but will need to be accompanied for a while for their safety.
- How frequent are the seizures?
- Are there any triggers for the seizures?
- What medication are they taking?
All this information can be recorded on an ID card available from the National Society for Epilepsy.
How to manage a convulsive epileptic seizure (tonic clonic or clonic - previously known as Grand Mal)
Most seizures happen without warning, last only a short time and stop without any special treatment. Injuries can occur, but most people do not come to any harm in a seizure, and do not usually need to go to hospital or see a doctor. When a person has a convulsive seizure it is possible that their regular breathing pattern will be interrupted and their colour may be blue. Although this can be frightening to witness, it does not usually mean it is a medical emergency. (This is explained in more detail below).
What to do during a convulsive seizure:
- Prevent others from crowding round.
- Put something soft under the person’s head (like a jacket or cardigan) to prevent injury.
- Only move if they are in a dangerous place, e.g. in the road, top of stairs.
- Do not attempt to restrain the convulsive movements. Allow the seizure to take its course.
Do not put anything in the person’s mouth. There is no danger of swallowing the tongue and teeth can easily be broken.
What to do when the seizure has stopped:
- Roll the person, if possible, on to their side into the recovery position.
- Wipe away any excess saliva and if breathing is still laboured check that nothing is blocking the throat such as dentures or food.
- Do all you can to minimise embarrassment. If the person has been incontinent, deal with this as privately as possible.
- Stay with the person giving reassurance until they have fully recovered.
It is a medical emergency and medical assistance should be sought if:
- Someone has injured themselves badly in a seizure.
- They have trouble breathing after a seizure.
- One seizure immediately follows another or the seizure lasts more than five minutes and you do not know how long they usually last.
- The seizure continues for longer than usual for that person.
Other seizure types may include:
Complex partial seizures:
The person becomes suddenly confused,wonders around aimlessley or acts as if they do not understand what they are doing (picks up objects, removes clothes, etc):
Do not restrain, but guide away from danger, such as wandering into the road; speak gently and calmly to the person to help reorientation to surroundings as quickly as possible. They may be confused for some time after the seizure and it is better to leave well alone than to keep offering help and have it rejected with what might be misunderstood as aggression.
Simple partial seizures:
In these types of seizures there is no loss of consciousness and the person is aware of what is happening to them. However, the seizure effects can be disturbing for the person experiencing them and reassurance and comfort may be appropriate. If this type of seizure is a warning (sometimes called an aura) that a convulsive seizure will follow, the person may need assistance in making themselves as safe as possible before it occurs.
Tonic and atonic seizures
The person falls and then recovers with or without confusion:
Reassure, check for injury and stay with them until fully recovered.
Absence seizures (previously known as petit mal)
The person has a brief interruption of conciousness.
This type of seizure is usually very brief, but the person may need to be guided away from danger.
How else can I help?
Due to loss of awareness or consciousness, people with epilepsy often do not know what happens to them during a seizure. Observers can provide vital information for the GP or neurologist which can be very helpful in making a diagnosis of epilepsy and what types of seizures are occurring, enabling the doctor to prescribe suitable anti-epileptic medication.
The following information may be helpful in this way:
- Keep a record of the dates and times that seizures occur.
- Where was the person? What was he or she doing?
- Did the person mention any unusual sensations, such as odd smell or taste?
- Did you notice any mood change, such as excitement, anxiety or anger?
- What brought your attention to the seizures? (a noise such as a fall or body movements such as eyes rolling or head turning).
- Did the seizure occur without warning?
- Was there any loss of consciousness or altered awareness?
- Did the person's colour alter, (eg: pale, flushed or blue). If so, where - Face, lips, hands?
- Did any parts of the body stiffen, jerk or twitch? If so which parts were affected?
- Did the person's breathing alter?
- Did the person perform any actions, eg.mumble, wander about, fumble with clothing?
- How long did the seizure last?
- Was the person incontinent?
- Did they bite their tongue?
- How were they after the seizure?
- Did they need to sleep? If so, for how long?
- How long was it before the person was able to resume their normal activities?
- Any other observations?
We are indebited to the National Society for Epilepsy for their help in compiling this section.
