Seizures can happen when there is abnormal electrical activity in the brain. They can affect part of the brain (focal seizures) or the entire brain (generalized seizures). Seizures are more common than you may think—about 1 in 10 people will have a seizure at some point.
Witnessing someone having a seizure can be upsetting. But there are many ways you can help—and some actions to avoid in order to give the person the best care, says Christopher Lewandowski, M.D., an emergency medicine doctor at Henry Ford Health.
“Stay calm, keep the person safe and note the duration of the seizure. Don’t restrain the person or put anything in their mouth. Watch for signs that the person needs emergency medical care, such as a seizure lasting five or more minutes.”
Signs And Symptoms Of Seizures
Seizures come on suddenly and can cause various symptoms, including falling, muscle spasms and loss of consciousness. The most common cause of recurrent seizures is epilepsy. Infections, abnormalities in the blood, and previous head injuries, concussions or strokes can also cause seizures.
Symptoms of a seizure usually last from 30 seconds to 1-2 minutes. A seizure affecting a portion of the brain can cause periods of confusion and loss of awareness (absent seizures). Symptoms of more severe seizures affecting both sides of the body (tonic seizures) include:
- Falling to the ground
- Having muscle spasms or shaking
- Becoming unconscious
- Losing bladder or bowel control
Seizure First Aid: Do’s And Don’ts
If you see someone having a seizure, Dr. Lewandowski recommends keeping the person safe by:
- Clearing the area: Sometimes, a crowd will gather when someone is having a seizure. Ask people to step away to allow the person privacy.
- Laying the person on their side: This position will prevent the person from swallowing or choking on any fluid or food in their mouth.
- Keeping the person comfortable: Place something flat and soft, like a folded blanket or jacket, under the person’s head. Remove eyeglasses and loosen tight clothing such as ties or scarves to prevent injuries.
- Timing the seizure: This information can help determine the severity of the seizure. People with a seizure disorder will know what’s normal for them and whether they need to contact their doctor.
When someone has a seizure, your instinct may be to try to stop jerky movements or help in other ways. However, Dr. Lewandowski explains that certain actions can actually be harmful. Avoid these actions:
- Restraint: There’s no need to try to restrain the movements of someone having a seizure. Stay nearby to keep the person safe and provide assistance once the seizure is over.
- Cardiopulmonary resuscitation (CPR): People continue to breathe during a seizure even if their chest muscles are tightening. Keep them on their side with their mouth facing downward so their airway stays clear.
- Opening the mouth: You may have heard that swallowing the tongue is a danger during a seizure. This does not occur, says Dr. Lewandowski, so there’s no need to try to prop their mouth open with an object.
- Medication or water: Don’t try to have someone take medication or drink water during a seizure episode. These actions could cause choking.
When the seizure is over, stay with the person and explain what happened. Make them comfortable and offer them food or water once they are fully awake.
Many people are exhausted after a seizure and need to rest for several hours—volunteer to help them contact a family member or friend for assistance. People with serious health conditions may wear a medical bracelet with emergency contact information.
When To Seek Emergency Care For A Seizure
Not all people who have seizures need medical care for every episode. But there are times when people need immediate medical care after a seizure. Call 911 for emergency medical assistance if the person has:
- Difficulty breathing
- A seizure lasting five minutes or longer
- Repeated seizures without waking between episodes
- Injuries from a seizure
- Seizures occurring in water
People who should go to the emergency room (ER) after a seizure include:
- Women who are pregnant
- People with diabetes or heart disease
- Individuals with a high fever or heat exhaustion
- People who have never had a seizure before
“We all want to help someone in distress but don’t always know what to do. By following these guidelines, you can keep someone safe during a seizure and call for medical assistance if needed afterward,” says Dr. Lewandowski.
Reviewed by Dr. Christopher Lewandowski, an emergency medicine doctor who sees patients at Henry Ford Hospital and Henry Ford West Bloomfield Hospital.