If you’ve ever witnessed someone having a seizure, you know it can be somewhat alarming. Seizures can occur without warning, causing a person to exhibit unusual, even frightening behavior. Bystanders want to help, but like most sudden health emergencies, a seizure can leave you feeling confused and helpless.
A seizure is a sudden burst of uncontrolled brain activity that may produce abnormal behavior, convulsions, or even loss of consciousness.
Seizures are caused by many factors, but the most common cause is epilepsy. Seizures may occur after a head injury or a stroke. Infections such as meningitis or other illnesses can cause seizures. Often, especially with a first-time occurrence, the cause is unknown.
HOW CAN YOU TELL IF SOMEONE IS HAVING A SEIZURE?
Signs and symptoms range from mild to severe and vary by individual and type of seizure. These signs may include:
- uncontrollable, jerking movements of the arms and legs
- loss of consciousness
- confusion or blank staring
- inability to speak or swallow
- a sense of unreality or déjà vu
- physical collapse due to loss of muscle control
- stiffening or shaking of the whole body
- loss of bladder control
Seizures are caused by a disruption in the communication pathways of the brain. Neurons (nerve cells) in the brain send and receive electrical impulses that communicate with the body for every movement and function. Among the causes of disruption that can lead to a seizure are:
- high fever (usually associated with an infection such as COVID-19 or meningitis)
- medications, including some pain relievers, antidepressants, and smoking cessation aids
- head trauma that results in a brain bleed
- brain tumor
- extreme intoxication or withdrawal from excessive alcohol use
- use of illegal drugs like cocaine or methamphetamines
- extreme sleep deprivation
WHAT YOU CAN DO
If you see someone having a seizure, the most important thing you can do is prevent them from injuring themselves or others. Since they are not in control of their body movements and probably cannot respond to directions, it’s up to the bystander to step in to help. Since most seizures last from 30 seconds to two minutes, there usually isn’t time to call for an ambulance—although any seizure lasting longer than five minutes should be considered a medical emergency.
Here’s what to do when someone is having a seizure.
- Help them to a lying down position wherever it is reasonably safe.
- Turn them on their side to help them breathe more easily.
- Place a rolled-up jacket under their head so their movements don’t cause injury.
- Remove their eyeglasses and any neckwear that could constrict breathing.
- Clear the area of anything sharp that could cause injury.
- Time the seizure. If it lasts more than five minutes, call 911.
WHAT NOT TO DO
Just as important as knowing what to do to keep a person safe during a seizure is knowing what NOT to do. The Centers for Disease Control and Prevention offers these important tips:
- Do not hold the person down or try to stop their movements.
- Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.
- Do not try to perform CPR or give mouth-to-mouth resuscitation. People usually start breathing again on their own after a seizure.
- Do not offer the person water or food until he or she is fully alert.
When the seizure ends, it may take the person a few minutes to return to full alertness. Once they are aware of you and able to communicate, explain to them what happened. Ask if they have a medical bracelet that will provide you with information about their condition. Offer to call a taxi or another person to take them home or to their medical professional.
Seek prompt medical attention for the person under any of the following circumstances:
- The person has a second seizure almost immediately.
- The person has a high fever or is experiencing heat exhaustion.
- The person is pregnant or has diabetes.
- The person has injured themselves during the seizure.
People who suffer periodic seizures might find it difficult to tell others about their health issue, but it’s important to inform a few key people—relatives, neighbors, friends, and coworkers—so they will know what to do if a seizure occurs. Many caregivers and other professionals are trained to respond to a seizure, such as school staffers and childcare providers, adult caregivers, first responders, and mental health professionals. But there is always a first time, and no one should be left to suffer alone while others stand by helplessly.
The best thing you can do is to remain calm and present with the person until the seizure passes. You will have provided what they need most—a compassionate gesture of support.
Mayo Clinic Staff. “Seizures.” Mayo Clinic website, accessed July 1, 2020. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711
“What Happens During a Seizure?” Northwest Florida Clinical Research Group, LLC Blog. July 19, 2017. http://www.nwflcrg.com/2017/07/19/what-happens-during-a-seizure/
“Seizure First Aid.” National Center for Chronic Disease Prevention and Health Promotion website. Page last reviewed Jan 10, 2019. https://www.cdc.gov/epilepsy/about/first-aid.htm