8/7/2019 Seizure Aid
1/16
What to do when someone has a seizure
epilepsy
rst aid
8/7/2019 Seizure Aid
2/16
A large print text only version of
this leaet is available from the
Epilepsy Helpline on:01494 601 400
(Monday - Friday 10am - 4pm)
rst aidUsually when a person has an epilepticseizure there is no need to call an
ambulance. However you should alwaysdial 999 for an ambulance if:
it is the persons rst seizure;
they have injured themselves badly;
they have trouble breathing after the seizurehas stopped;
one seizure immediately follows another with
no recovery in between;
the seizure lasts two minutes longer than is
usual for them; or the seizure lasts for more than ve minutes
and you do not know how long their seizures
usually last.
These guidelines are particularly relevant for
tonic clonic (convulsive) seizures (see page 8).
8/7/2019 Seizure Aid
3/16
What to do when someone has aseizure
Knowing how to help someone during and
after an epileptic seizure may help you, and
them, feel more condent if a seizure
happens. How you can help the person may
depend on the type of seizures they have.
If you know the person, they may have told
you about their epilepsy and how you can
help them if they have a seizure. If you dont
know about their epilepsy, this leaet gives
you some general guidance on how you can
help if they have a seizure.
Epileptic seizures
The brain is made up of millions of nerve
cells which control the way we think, move
and feel. The nerve cells do this by passingelectrical signals to each other. In some
people, these signals may suddenly be
interrupted, and this can cause an epileptic
seizure (sometimes called a t or attack).
Are all epileptic seizures the same?
There are many different kinds of epileptic
seizure. How epilepsy affects one person can
be different to how it affects someone else.
Some people have more than one type
of seizure.
Some people only have seizures when
they are awake.
3
8/7/2019 Seizure Aid
4/16
Some people have nocturnal seizures.
Nocturnal seizures happen when the
person is sleeping. The name does not
explain what type of seizures they are,
only that they happen when the person is
asleep.
Some people have seizures when they
are awake and when they are asleep.
Most seizures happen suddenly, without
warning, last a short time (a few seconds
or minutes) and stop by themselves.
Injuries can happen during a seizure, but
most people do not hurt themselves and
do not usually need to go to hospitalor see a doctor. (See inside front cover
for details about when to call for an
ambulance).
Types of epileptic seizures and what to doEpileptic seizures can be divided into two
main types: partial seizures and generalised
seizures. Seizures can vary from one person
to another and how people are affected and
how they recover after seizures also varies.See NSE leaet epilepsy - seizures for
more information about seizure types.
Partial seizures
In partial seizures the seizure starts in, and
affects, just part of the brain. What happens
during the seizure depends on where in the
brain the seizure happens and what this part
of the brain does.
4
8/7/2019 Seizure Aid
5/16
Simple partial seizures
In a simple partial seizure (SPS) the person
is conscious (awake) and aware of what is
happening to them. A SPS could be
twitching of one limb or part of a limb, an
unusual smell or taste, a strange feeling such
as a rising sensation in the stomach or pins
and needles in part of the body, or a sudden
intense feeling of fear or joy.
What to do during the seizure:
although the person is awake and aware,
SPS can feel unsettling so giving gentle
reassurance may be helpful.
Complex partial seizures
A complex partial seizure (CPS) affects a
bigger part of the brain than a SPS. In a
CPS the persons consciousness is affectedand they may be confused. You might
notice them wandering around or behaving
strangely and they may not know what they
are doing. They may pick objects up for no
reason, ddle with their clothes or makechewing movements with their mouth.
Afterwards, they may need to sleep; or they
might be confused for some time. CPS may
last from a few seconds to a few minutes.
What to do during the seizure:
do not restrain them as this may upset or
confuse them;
5
8/7/2019 Seizure Aid
6/16
gently guide them away from dangerous
situations (such as walking into the
road); and
speak quietly and calmly so that they are
not startled. They may be confused, so if
you speak loudly or act forcefully this
may confuse them more. They may
mistake your help for being hostile, and
respond in an upset or aggressive way.
After the seizure stops:
they may feel tired and need to sleep;
they may be confused and not fully
aware of their surroundings so it mayhelp to remind them where they are; and
stay with them until they have recovered,
and can safely return to what they were
doing before the seizure.
Some people recover quite quickly after theirseizures, others may take longer to feel
normal again.
Secondarily generalised seizures
For some people SPS and CPS develop intoa generalised seizure (see below). When this
happens the person becomes unconscious
and will usually have a tonic clonic seizure.
This is called a secondarily generalised
seizure because it starts as a partial seizure
and then becomes generalised. Some people
call their partial seizure an aura or warning
because it warns them that a generalised
seizure may follow.
6
8/7/2019 Seizure Aid
7/16
What to do during the seizure:
if they are aware of an aura, they may
need help to make themselves safe
before the generalised seizure starts.
Generalised seizures
Generalised seizures affect all of the brain at
once. The person becomes unconscious and
afterwards will not remember what happened
during the seizure.
Absences (sometimes called petit mal)
During an absence a person becomes
unconscious for a short amount of time,usually a few seconds. They may look blank
and not respond to what is happening around
them. For example, if they are walking they
may continue to walk, but will not be aware
of what they are doing during the absence.
What to do during the seizure:
stay with them, and if necessary, gently
guide them away from any danger.
Tonic and atonic seizures
In a tonic seizure the persons muscles
suddenly become stiff. If they are standing
they often fall backwards and may injure the
back of their head. In an atonic seizure
(also called a drop attack) the persons
muscles suddenly relax, and they become
oppy. If they are standing they often fall
forwards and may injure their face or head.
7
8/7/2019 Seizure Aid
8/16
Tonic and atonic seizures tend to be very
brief and happen without warning. People
usually recover quickly.
What to do after the seizure:
as they recover they may need
reassurance. If they have been injured,
they may need medical help.
Myoclonic seizures
Myoclonic seizures involve the jerking of a
limb or part of a limb. They are brief and can
happen in clusters with many happeningclose together in time. They often happen
shortly after waking up from sleep. As they
are so brief, there is nothing that needs to be
done to help the person other than making
sure they havent hurt themselves.
Tonic clonic (convulsive) seizures
(sometimes called grand mal seizures)
When a person has a tonic clonic seizure
they usually fall to the ground and makeshaking or jerking movements. During the
seizure their breathing might be affected and
they may go pale or blue, especially around
their mouth. They may also bite their tongue.
Although this can be frightening to see,
these seizures are not usually a medical
emergency. Usually, once the jerking has
stopped, the person recovers and their
breathing goes back to normal.
8
8/7/2019 Seizure Aid
9/16
9
What to do during the seizure:
try to stay calm;
note the time to check how long the
seizure is going on (because there may
be a risk of status - see page 11);
move objects, such as furniture, away
from the person if there is a risk of
injury. Only move the person if they are
in a dangerous place; for example, at the
top of stairs or in the road. See photo 1;
put something soft (like a jacket or
cushion) under their head, or cup their
head in your hands, to stop their headhitting the ground. See photo 2;
do not restrain them, allow the seizure to
happen;
do not put anything in their mouth - there
is no danger of them swallowing theirtongue during the seizure; and
try to stop other people from crowding
around.
photo 1 photo 2
8/7/2019 Seizure Aid
10/16
10
What to do when the jerking (convulsing)
has stopped (recovery):
roll them on to their side into the
recovery position (see page 15);
wipe away any spit and if their breathingis difcult check their mouth to see that
nothing is blocking their airway, like food;
try to minimise any embarrassment. If
they have wet themselves, deal with this
as privately as possible; and stay with them, giving reassurance, until
they have fully recovered.
Some people recover quickly after these
seizures but more often the person will be
very tired, may want to sleep and may not
feel back to normal for several hours or
sometimes days.
Status epilepticus
Most peoples seizures last the same length
of time each time they happen, and usually
stop by themselves. However, sometimes
seizures do not stop, or one seizure followsanother without the person recovering in
between. When a seizure goes on for 30
minutes or more it is called status epilepticus,
or status for short.
Usually when a person has a tonic clonicseizure there is no need to call for an
ambulance. However you should always dial
999 for an ambulance if:
it is their rst seizure;
they have injured themselves badly; they have trouble breathing after the seizure
has stopped;
one seizure immediately follows another with
no recovery in between;
the seizure lasts two minutes longer than
usual for them; or
the seizure last for more than ve minutes
and you do not know how long their seizures
usually last.
8/7/2019 Seizure Aid
11/16
11
Status epilepticus
Most peoples seizures last the same length
of time each time they happen, and usually
stop by themselves. However, sometimes
seizures do not stop, or one seizure followsanother without the person recovering in
between. When a seizure goes on for 30
minutes or more it is called status epilepticus,
or status for short.
Status can occur in any type ofseizure and the person may need to see a
doctor. However, status in a tonic clonic
(convulsive) seizure is a medical emergency.
It is important to call for an ambulance before
the seizure goes on too long. Do not wait
until it has lasted 30 minutes before calling
for help.
See the information box on page 10
for when to call for an ambulance.
Some people who go into status areprescribed a form of emergency (or rescue)
medication called diazepam to stop their
seizures. Sometimes this is given rectally
(into the persons bottom). Carers will need
training on how to give rectal diazepam and itis important to have a written protocol (plan)
for each individual, for the carer to follow.
See NSE leaets epilepsy medication
for adults or epilepsy medication
for children for more information aboutmedication for status.
8/7/2019 Seizure Aid
12/16
12
How else can I help?
Because people are often not fully aware
during their seizures they might not know
what happens to them. Other people who
have seen the seizures can often provideuseful information for the GP or neurologist.
An eyewitness description like this may
help to diagnose and identify what type of
seizures a person is having.
If you see someone having a seizure, it can
be helpful to note the following things.
Where were they and what were they
doing before the seizure?
Did you notice their mood change - were
they excited, anxious or quiet?
Were there any triggers for the seizure
did they feel tired, hungry or unwell?
Did they have any warning that the
seizure was going to happen?
Did they have any unusual sensations,such as an odd smell or taste?
What made you notice the seizure (a
noise, did they fall or did their eyes roll)?
Did they appear to be blank or stare
into space? Did they lose consciousness or were
they confused?
Did they do anything unusual such as
mumble, wander about or ddle with their
clothing? Did their colour change (become pale or
ushed) and if so, where (face or lips)?
Did their breathing change (e.g. become
noisy, or look difcult)?
8/7/2019 Seizure Aid
13/16
13
Did any part of their body move, jerk or
twitch?
Did they fall down, or go stiff or oppy?
Did they wet themselves?
Did they bite their tongue or cheek? How long did the seizure last?
What were they like after the seizure?
Did they need to sleep?
How long was it before they were able to
carry on as normal? Did you notice anything else?
What do I need to know about someones
epilepsy?
There are some things it can be useful to
know about someones epilepsy, so you can
help them if they have a seizure.
What types of seizures do they have?
For example, complex partial seizures or
absences.
How long do their seizures normally last?Epileptic seizures usually stop by
themselves. Although the length of
seizures is different from person to
person a seizure usually lasts the same
length of time for each person. How often do they have seizures?
Some people keep a note of when their
seizures happen, in a seizure diary.
Contact NSE for a free seizure diary.
Are their seizures usually triggered orbrought on by anything, such as stress
or tiredness?
Do they have a history of status? If so,
do they need emergency medication?
(See page 11).
8/7/2019 Seizure Aid
14/16
8/7/2019 Seizure Aid
15/16
8/7/2019 Seizure Aid
16/16
onalS
ocietyforEpilepsyMay20
07
Join NSEs Associate Membership Scheme
to receive regular information about epilepsy.
Please contact the Associate Membership
Co-ordinator on 01494 601 402 for details.
For other information please write to
Epilepsy Information Services
National Society for Epilepsy
Chesham Lane
Chalfont St. Peter
Bucks SL9 0RJTelephone 01494 601 300
Fax 01494 601 337
www.epilepsynse.org.uk
Epilepsy Helpline
01494 601 400Monday - Friday 10am - 4pm
Every effort is made to ensure that all our information is
correct and up to date. Please note that some information
may change after the date of printing. This information is not
intended to be a substitute for medical guidance from your
own doctors. NSE cannot be held responsible for any actions
taken as a result of using NSE information resources.
Registered Charity Number 206186.
Founded in 1892. Patron Her Majesty The Queen.
Top Related