According to the Centers for Disease Control and Prevention, approximately 1 in 10 people will suffer a seizure during their lifetime. You don’t have to have epilepsy to have a seizure, and they happen more often than you might think – knowing what to do in the event of a seizure can help you feel prepared and less likely to panic if you see one happen.
What is an epileptic seizure?
Seizures are a loss of function or alteration of behaviour caused by a disturbance in the brain’s electrical activity. During normal function, the brain generates small electrical pulses at regular intervals. These pulses travel along the brain’s neurons and throughout the body via chemical messengers called neurotransmitters. In people with epilepsy, the brain’s normal electrical patterns can often become imbalanced, causing a seizure.
Types of epileptic seizure
Seizures are so varied that they can be classified into many different types, each of which fall into one of three overarching categories: focal onset, generalised onset and unknown onset seizures.
Generalised onset seizures
These types of seizures are surges of erratic electrical activity that affect both sides of the brain at once. They are usually caused by an imbalance in the inhibitory circuits or “brakes” and excitatory circuits or “accelerators” of the brain’s electrical activity.
For those with the tendency to have generalised onset seizures, a lack of sleep or drinking too much alcohol can increase the risk of having one.
Absence seizures
During an absence seizure, the person may appear to be daydreaming. They will stare blankly for a few seconds, may not respond when spoken to, and are often unaware they just experienced a seizure.
This kind of seizure occurs most often in children and doesn’t usually cause any long-term issues.
Tonic-clonic seizures
This is the type of seizure most people imagine when they think of epilepsy. The affected person will stiffen and convulse before losing consciousness and may fall to the ground. Loss of bladder control is also possible. Tonic-clonic seizures usually last between one and three minutes. If a tonic-clonic seizure lasts more than five minutes, emergency medical treatment may be necessary.
After a tonic-clonic seizure, the affected person may have a headache and feel tired and sore.
Tonic and atonic seizures
This kind of seizure may cause the affected person to lose consciousness briefly, stiffen and fall to the ground. As the person has lost control of their muscles, they may be injured from the fall.
Myoclonic seizures
This type of seizure is characterised by rhythmic muscle jerks that affect the whole body and can be strong enough to cause the affected person to fall to the floor.
Focal onset seizures
Focal onset seizures occur in one area or affect a group of cells in one side of the brain. These seizures are the most common type experienced by people with epilepsy.
When the seizure causes the affected person to lose some level of awareness during it, it’s known as a focus impaired awareness seizure. Conversely, when the affected person is awake and aware during the seizure, it’s called a focal aware seizure.
Auras
Some people with epilepsy experience a particular sound, smell vision or feeling shortly before a seizure begins. This sensation is called an “aura” and is itself a focal seizure.
Focal aware seizures
A person with epilepsy may occasionally experience unusual sensations or movement in one part of the body like twitching or tingling.
Focal impaired awareness seizures
The affected person may experience odd feelings and their awareness may be impaired or completely gone. They may become unable to respond when spoken to and their behaviour may seem unusual.
When starting in the temporal lobe, these seizures usually last two to three minutes and may include:
- Picking things up or fiddling with clothing
- Making a chewing movement or smacking their lips
- Muttering or repeating words
- Wandering around in a confused state
When starting in the frontal lobe, these seizures usually last 15-30 seconds and may include:
- Making strange movements or postures
- Crying out
Unknown onset seizures
When the cause of a seizure isn’t known, it’s referred to as an unknown onset seizure. If a seizure happens and isn’t witnessed by anyone else, it could also be classified as unknown onset. As more information is acquired, an unknown onset seizure is often later diagnosed as a focal or generalised onset seizure.
First aid for seizures
A seizure might be scary to witness, but it’s important not to panic. Most seizures don’t require you to call for emergency medical assistance, and there are some simple things you can do to make sure the affected person is safe.
What to do when someone is having a seizure
If you’re with someone while they’re having a seizure, take the following steps:
- Only try to move the affected person if they’re in immediate danger, like near a busy road or a hot stove
- Cushion their head if they’re on a hard surface or otherwise at risk of hitting it
- Loosen any tight clothing that could constrict their breathing, like a tie or collar
- If the affected person is in a wheelchair, put the breaks on and leave their harness or seatbelt on if one is present. Cushion their head and gently support them, but to not attempt to restrain or move them.
- Never put anything in the affected person’s mouth, including your fingers
What to do once a seizure has subsided
After a seizure has subsided, the affected person may be feeling sore and tired, or may be unconscious. Take the following steps:
- If the affected person is conscious, stay with them and talk to them calmly until they recover
- If the affected person is unconscious, check their airway and breathing before placing them in the recovery position
- They should not have any food or drink until they have fully recovered
When should you call an ambulance for a seizure?
You should call for an ambulance on 999 if:
- It’s the first time the person has had a seizure
- The seizure lasts longer than it usually does for them
- The seizure lasts for longer than 5 minutes
- The person does not regain full consciousness or has many seizures without regaining consciousness
- The person is seriously injured during the seizure
Responding to seizures is part of our 3-Day First Aid at Work course. Acquire more in-depth first aid knowledge and become a qualified first aider by attending one of our Ofqual Accredited First Aid Courses.
Read our other blogs for more information on first aid or contact us to book a first aid course today.