Brain & Nervous System Epilepsy First Aid for Epilepsy Seizures Taking care of someone who's having a seizure By Reza Shouri, MD Reza Shouri, MD Reza Shouri, MD, is an epilepsy physician and researcher published in the Journal of Neurology. Dr. Shouri has always been fascinated with the structure and function of the human brain. Learn about our editorial process Updated on January 17, 2020 Medically reviewed by Shaheen Lakhan, MD, PhD Medically reviewed by Shaheen Lakhan, MD, PhD LinkedIn Shaheen Lakhan, MD, PhD, is an award-winning, board-certified physician-scientist and clinical development specialist. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What a Seizure Looks Like Warning Signs How to Help During a Seizure When to Call 911 After the Seizure Caregiving 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. 1:44 Knowing What to Do When Someone Has a Seizure 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, as do the seizures it causes. If you know the type of seizures a person experiences, you can learn what symptoms to watch for. Seizures and Their Symptoms 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 to 2 minutes Person is partly or completely unaware; blank stare; repeated action (i.e., chewing, rubbing fingers); cold to the touch Absence < 10 seconds Person is unaware; spacing out; most common in children 4 to 14 Tonic 1 to 3 minutes Muscles stiffen, may cause person to fall; loss of consciousness Atonic < 15 seconds Muscles become limp, may cause collapse Myoclonic 1 to 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 to 3 minutes Muscles stiffen, may cause fall; loss of consciousness; arms and possibly 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. It's estimated that around 1 percent of the population of the United States has epilepsy. 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 déjà 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 (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. Illustration by JR Bee for Verywell Health According to the Epilepsy Foundation, you should call 911 when: Someone without a history of seizures has oneA seizure lasts five minutes or longerSeizures occur one after another without the person becoming conscious in betweenSeizures occur closer together that is typical for that personThe person has trouble breathing or is chokingThe 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. Use your judgment. Even if none of the above criteria are met, if something seems out of the ordinary for someone, call 911. 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 If you're around someone with epilepsy, you may want to look into epilepsy first aid training. The Centers for Disease Control (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 offers 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. 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. How Seizures Are Caused 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Neurological Disorders and Stroke. The epilepsies and seizures: Hope through research. Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015. MMWR Morb Mortal Wkly Rep 2017;66:821–825. doi:10.15585/mmwr.mm6631a1 Brodie MJ, Zuberi SM, Scheffer IE, Fisher RS. The ILAE classification of seizure types and the epilepsies: what do people with epilepsy and their caregivers need to know? Epileptic Disorders. Centers for Disease Control and Prevention. Seizure first aid. Epilepsy Foundation. First aid for seizures -- stay, safe, side. Josephson CB, Engbers JD, Sajobi TT, et al. An investigation into the psychosocial effects of the postictal state. Neurology. 2016;86(8):723-30. doi:10.1212/WNL.0000000000002398 Brennan M, Whitehouse F. Case study: seizures and hypoglycemia. Clinical Diabetes. 2012;30(1):23-24. doi:10.2337/diaclin.30.1.23 Additional Reading Noble A, Marson A, Tudur-Smith C, et al. Seizure First Aid Training’ for People with Epilepsy Who Attend Emergency Departments, and Their Family and Friends: Study Protocol for Intervention Development and a Pilot Randomised Controlled Trial. BMJ Open. 2015. 5(7):e009040. doi: 10.1136/bmjopen-2015-009040. Snape D, Morgan M, Ridsdale L, et al. Developing and Assessing the Acceptability of an Epilepsy First Aid Training Intervention for Patients who Visit UK Emergency Departments: A Multi-Method Study of Patients and Professionals. Epilepsy and Behavior. 2017. 68:177-185. doi: 10.1016/j.yebeh.2017.01.006. By Reza Shouri, MD Reza Shouri, MD, is an epilepsy physician and researcher published in the Journal of Neurology. Dr. Shouri has always been fascinated with the structure and function of the human brain. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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