How to Help Someone Who's Having a Seizure

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The odds of experiencing a seizure, whether it happens to you or some around you, are higher than you may think. Abby Crow, ARNP, UnityPoint Health, says they’re “surprisingly common” and estimated to happen in one of every eight to ten people. About two percent of emergency room visits each year are because of a seizure. Knowing what to look for before and during a seizure — and how to help someone experiencing this clinical condition — might come in handy at some point.

What Causes Seizures?

“A seizure is essentially the interruption of normal connections between nerve cells in the brain,” says Crow. They’re most common in someone with a seizure disorder or epilepsy.

What is Epilepsy?

Epilespy is a neurological disorder that involves abnormal electrical activity in the brain. Epilepsy symptoms vary. Some people can lose awareness or have a brief blank stare. Sometimes a person may have convulsions or shaking, which involves the legs and arms twitching. These symptoms don’t happen to everyone though. However, epilepsy can happen in anyone, regardless of their race, gender or age and is caused by a number of reasons, including:

  • Genetics. It’s either passed down from a parent or happens spontaneously.
  • Structural abnormalities. There’s a physical issue in the brain that significantly raises the risk for seizures.
  • Metabolic disorders. The process your body goes through to break down food and create energy malfunctions.
  • Immune system changes. A protein causes inflammation in the brain. Most people affected have an abnormal antibody in their spinal fluid or blood.
  • Infection. Brain infections that cause epilepsy are common but more so in developing countries.
  • Unknown. In many cases, the cause for epilepsy can’t be found.

Additional causes for seizures in adults, unrelated to epilepsy, can include:

  • Abnormalities in the temporal lobe. These are the areas in your brain where short-term memories and emotions are processed.
  • Cerebrovascular disease. A condition where there’s a problem with blood flow and blood vessels in the brain.
  • Vascular malformation. When blood vessels in the brain develop abnormally — a condition you’re typically born with.
  • Brain lesions or tumors. These are brain abnormalities found during imaging.
  • Previous head injuries. Traumatic brain injuries can cause swelling, bruising and bleeding in or near the brain.
  • Neurodegenerative conditions. Alzheimer’s disease and dementia are examples of this.

Crow says acute symptomatic seizures are another type of this clinical condition and have a wide variety of causes, ranging from acute head trauma, stroke, low blood oxygen levels, elevated thyroid hormones, low or high blood sugar levels and more.

What Do Seizures Look Like in Children?

According to the National Institute of Neurological Disorders and Stroke, febrile seizures are rare and only affect between two and five percent of American children younger than five years old, although they’re most common in children under two years old. They’re typically caused by a sudden spike in body temperature and occur on the first day a child starts feeling unwell. Common symptoms of a febrile seizure include:

  • A fever greater than 101 °F
  • Loss of consciousness
  • Uncontrollable shaking of all extremities
  • Stiffness in the body
  • Rolling of the eyes

Not all children experience all symptoms, though, and while frightening, they’re usually over quickly and don’t cause any long-term harm. Crow advises caregivers to always seek medical attention following the first occurrence of a febrile seizure and follow the first aid steps below.

What to Do During a Febrile Seizure

Seek medical attention immediately if it's a child's first febrile seizure and follow these first aid steps.

Do Don't
Remove objects around the child that could cause injury DO NOT put anything in their mouth
Turn them on their side to help keep their airway open DO NOT hold the child down
Cushion their head with a pillow or jacket DO NOT attempt to give CPR, even if they don't appear to be breathing normally
Remove eyeglasses or clothing items that could make breathing difficult DO NOT offer food or drink until they're fully awake and talking
Stay with the child  

How Long Does a Typical Seizure Last?

While it might feel like an eternity, a typical seizure lasts less than two minutes. However, Crow says if a seizure lasts longer than five minutes to call 911 right away.

Seizure Warning Signs

Experiencing an aura can be a warning sign of an impending seizure and may occur several seconds, or up until an hour, before a seizure begins. “While not every seizure will have an aura — many do,” Crow says. “An aura is a feeling, experience or body movement that doesn’t feel normal. It can include things like visual changes, feelings of déjà vu or impending doom, hearing noises that aren’t there, unpleasant taste or smells and/or strong emotions without a clear cause.”

Seizure Symptoms

So, what does a seizure look like? Symptoms during a seizure vary depending on if it’s a focal or generalized seizure and the cause of it. A focal seizure happens on one side of the brain. A generalized seizure happens on both sides of the brain. Crow says a common symptom people experience is known as a “post-ictal phase,” where someone might feel excessively sleepy or confused.

“A seizure may or may not be associated with an altered state of consciousness. The most common type of seizure people think of is a generalized tonic-clonic or grand mal seizure,” says Crow.

A grand mal seizure is typically associated with the following symptoms:

  • Interrupted consciousness
  • Jerking body movements
  • General shaking
  • Falling
  • Screaming or crying out
  • Becoming unaware of your surroundings

Crow says other types of seizures may look like a tremor, inattention or a repetitive tic.

Seizure First Aid

If you have a loved one with a seizure disorder or are ever in a scenario where someone around you is having a seizure, there are general things you can do to help.

Never leave someone having a seizure unattended unless it’s to call 911. Crow says because people can’t swallow during a seizure, it’s also important to never put anything into the person's mouth while they’re seizing, including any type of medication or liquid.

“Do not try to hold the person down, restrain their movements or attempt to give them CPR even if they don’t appear like they’re breathing normally. Their breathing should resume after the seizure has stopped. Additionally, don’t offer any drink or food until the person is fully awake and talking,” she says. 

What to Do When Someone Has a Seizure

Do Don't
Look around for any environmental hazards that could cause more harm. Do not put anything in their mouth.
If necessary, assist the person to the ground into a side laying position to help keep their airway open. Do not restrain or hold the person down.
Remove potential hazards or sharp objects from the area. Do not attempt to give CPR, even if they don’t appear to be breathing normally.
Place a soft pillow or folded jacket under the person’s head. Do not offer food or drink until the person is fully awake and talking.
Remove any eyeglasses or clothing items that could interfere with the ability to breathe, such as neckties or necklaces. Do not call 911 unless the seizure lasts 5 minutes or more.
Stay with the person.  
Time the seizure.  If it lasts for more than five minutes, call 911.  
 If you’re unsure whether the person has a seizure disorder, check for a medical alert bracelet or necklace.  
 Try to stay calm.  

When to Call 911 During a Seizure

While your gut reaction might be to call 911 during a seizure, Crow says there are certain circumstances where it’s necessary and others where the person’s doctor should be notified versus emergency personnel.

“People with a known seizure disorder may keep a log instead of reporting each individual event to their doctor. First-time seizures should always receive prompt medical attention, though.”

When to call 911 for a seizure:

  • The seizure lasts longer than five minutes.
  • The person has never had a seizure before.
  • The person is having trouble breathing or not waking up after the seizure.
  • The person begins seizing again before returning to a conscious state.
  • The person is pregnant, injured or sick.
  • The seizure occurs in the water.
  • The person seizing injures themselves.
  • The person has known health conditions like diabetes or heart disease.

What to Do After Someone Has a Seizure

Experiencing a seizure for the first time can be frightening. Whether it happens to you or a loved one, you’ll likely have a lot of questions about why it happened and where to go from here. The emergency room is the best place to go the first time a seizure occurs to rule out any serious medical problems. There, the doctor caring for you might conduct a neurological exam and run blood, urine and/or imaging tests to get a full picture of what happened.

When you leave, notify your primary care provider about your seizure. They’ll likely refer you to a neurologist, a specialist who treats disorders of the brain, spinal cord and nerves. Your neurologist will help you with any seizure-related care — including a diagnosis and treatment plan.