First Aid for Epilepsy Seizures

Taking care of someone who's having a seizure

Checking the pulse of someone who has collapsed and is having a seizure
What should you do if you see someone having a seizure?. RunPhoto/Getty Images

First aid for epileptic seizures is mostly designed to keep the person safe. A seizure can be a scary thing to witness—especially if you don't know what to do. If someone in your life has a history of seizures, you can be most helpful to them if you learn what you should and shouldn't do when a seizure strikes.

What a Seizure Looks Like

Epilepsy is a neurological condition in which electrical disturbances in the brain lead to seizures. Not all seizures look alike, though. Epilepsy comes in many different forms and so do the seizures it causes. If you know the type of seizures a person has, you can learn what symptoms to watch for.

Types of Seizures
TYPE LENGTH VISIBLE SYMPTOMS
Focal aware < 2 minutes Person is awake and aware; may be unable to respond; muscle jerking, stiffening, or limpness
Focal impaired awareness 1-2 minutes Person is partly or completely unaware; blank stare; repeated action (i.e., chewing, rubbing fingers); freezing
Absence < 10 seconds Person is unaware; spacing out; most common in children 4-14
Tonic 1-3 minutes Muscles stiffen, may cause person to fall; loss of consciousness
Atonic < 15 seconds Muscles become limp, may cause collapse
Myoclonic 1-2 seconds Sudden, quick jerks in the arms or legs
Clonic < 1 minute Sudden, quick jerks that are repetitive; usually part of a tonic-clonic seizure
Tonic-clonic 1-3 minutes Muscles stiffen, may cause fall; loss of consciousness; arms and maybe legs jerk/twitch rapidly and repeatedly

The final type, tonic-clonic, is what used to be referred to as a grand mal seizure. It's the convulsive type most people think of when they picture a seizure and the type that most requires help and first aid.

Warning Signs

Seizures typically don't have warning signs that the casual observer can see.

However, many people with epilepsy have what's called an aura before a seizure. Auras vary widely and can include visual hallucinations, feelings of deja vu, or nausea.

It may not be obvious that the person is experiencing an aura, but they may have certain behaviors or "tells" that can let you know what's happening. Ask the person you know with epilepsy, or someone who spends a lot of time with them, what to look for.

If you suspect a seizure is coming on, there's nothing you can do to prevent it. However, you may be able to help the person lie down or get to a safe place before it strikes.

How to Help During a Seizure

When someone is having a seizure, your main goal is keep them from being injured. Here's what to do if you see someone go into a seizure:

  • Don't panic. Take deep breaths and remain calm.
  • When possible, note the time the seizure began so you'll know if it goes on too long (defined as five minutes or more)
  • If they're sitting in a chair, gently guide them to the floor or try to prevent them from falling. Head injuries are common and usually result from the fall at the onset of the seizure.
  • Move all heavy or sharp objects away from them. This includes tables, chairs, or any other hard furniture.
  • Try placing something soft, like a jacket or blanket, beneath the person's head to help prevent head injuries.
  • Remove their eyeglasses if you can safely do so.
  • If possible, roll them onto their side.
  • While it may be helpful to loosen belts or ties to help them breathe easier, never hold somebody down during a seizure.
  • Stay with them until the seizure is over, then be sensitive and provide support

You may have heard the old myth about the risk of someone choking on their own tongue during a seizure. This isn't something that actually happens, and if you try to force something in their mouth, you could end up injuring them or getting bitten.

When to Call 911

After someone has a seizure, it's common for them to remain unconscious for a short period of time. As long as they're breathing and uninjured, you may not need to get emergency medical help.

According to the Epilepsy Foundation, you should call 911 when:

  • A seizure lasts five minutes or longer
  • Seizures occur one after another without the person becoming conscious in between
  • Seizures occur closer together that is typical for that person
  • The person has trouble breathing or is choking
  • The person asks for medical attention

It's also important to seek emergent help if the seizure occurs in water or if an injury occurs due to the seizure.

It's also important to use your judgment. Even if none of the above criteria are met, if something seems out of the ordinary for this person, call 911.

What if It's Their First Seizure?

If someone without a history of seizures has one, it's important that you call 911 right away.

After the Seizure

When the person wakes up after the seizure, they may be disoriented and not know what happened. Doctors call this the "postictal state." Reassure the person that everything is OK and calmly let them know what happened. It's important to make sure that any injuries are taken care of.

If you have called for emergency help, the paramedics (and emergency physician) may ask you what the person was doing just prior to having the seizure. In some cases this information can be helpful in determining seizure triggers. Let the emergency staff know about any other conditions the person has that may contribute to seizures. For example, some people with diabetes and epilepsy may have low blood sugar before a seizure starts.

Caregiving

It's estimated that around one percent of the population has epilepsy, and 40 percent of them have at least two seizures per year.

If you're around someone with epilepsy, you may want to look into epilepsy first aid training. The CDC offers programs for several types of professional people who are likely to encounter seizures, such as school staff, law enforcement, childcare workers, and those who take care of older adults.

If someone in your family has epilepsy, you might want to consider having seizure drills, so everyone can practice responding to them the right way. Also, check with your local Red Cross or other organization that offer first aid training to see if they have special seizure training classes.

The Red Cross offers a first aid app that may be helpful during a seizure or other medical crises.

A Word From Verywell

The first time you witness a seizure, it can be pretty upsetting. It's normal to have a variety of emotions about it. Take the time to talk to someone about your experience. It might also be a good time to try some relaxation exercises such as deep breathing. If you're having trouble adapting to an epilepsy diagnosis in someone you care about, it's OK to ask for help. You may want to consider a mental-health therapist or family counselor to help get you, and possibly other loved ones, get through it.

Was this page helpful?