What to do if someone has an epileptic seizure

Photo of young man Photo of young man in a white shirt (Stockbyte / Stockbyte / Thinkstock) Most people are not sure how to react if someone has an epileptic seizure. The correct response is not that complicated, though. Just a few rules can help you remember what to do.

There are different types of epileptic seizures. The best reaction will depend on the type and severity of the seizure as well as the general situation. The main thing is to stay calm and protect the person having the seizure from harm. Most seizures are not dangerous and pass within a few minutes.

Minor seizures and seizures that affect consciousness

Some seizures only cause people to lose consciousness for a short time, or only cause muscles to twitch. These kinds of minor seizures are usually not dangerous. But they can still be unsettling or frightening for the person who has them, and they may feel unwell. So it can be important to comfort them and make them feel safe.

Some seizures have a major effect on consciousness and the person may then show especially unusual behavior. They might seem confused or lost. Then it is particularly important to keep them from doing something dangerous like walking onto the street. If possible, you should calmly try to lead them out of the situation without the use of unnecessary force.

Panicking and treating the person roughly may provoke an unexpected response. It is better to provide support and let them know you are there for them. Just "being there" can be helpful. This is also important while they are recovering from a seizure.

Major seizures

The following advice applies to major seizures with convulsions throughout the person's entire body that also cause them to lose consciousness and fall down:

  • Prevent injury: It is especially important to prevent injury to their head. For instance, you could put a jacket or pillow under their head and move any dangerous objects out of the way. During the seizure the person should under no circumstances be held or pushed against the ground. You should allow the seizure to run its course as much as possible.
  • Keep their airways free: Loosen any tight clothing around the person's neck. The person having the seizure may bite their tongue. But you should still not open their mouth during the seizure or put anything between their teeth. It is important to check that their airways are clear after the seizure.
  • Stay there: Do not leave the person alone, even to get help. Unless it becomes absolutely necessary because the seizure does not stop.
  • Watch a clock to see how long the seizure lasts: Seizures usually start suddenly and are over after one or two minutes. They rarely last longer than five minutes. If one does, then it is an emergency and you need to call the emergency services (e.g. 112 in Germany and most other European countries, 911 in the U.S.) for help.
  • After the seizure , stay and help: A person who has just had a seizure may need some time to recover from it. They may want something or need help getting oriented. Some people get very tired and would like to sleep right away. It is best to get them into the recovery position. It is also important to be sensitive to embarrassing situations and, for instance, keep people from forming a crowd if the seizure happens in public. The person might accidentally urinate during the seizure. In that event you can cover them with a jacket or blanket to avoid embarrassment and keep them warm.

Illustration: Recovery positionRecovery position

When do you need to call the emergency services?

It is not always necessary to call an ambulance when someone has a major seizure: If it is over quickly and the person is conscious and responsive right afterwards, you can talk to them about whether or not to call. It is only necessary in the following situations:

  • The seizure lasts longer than five minutes.
  • The person has had several seizures in a row.
  • The person has breathing difficulties.
  • They injured themselves.
  • You know that it is their first seizure.
  • The person does not regain consciousness.

Some people who have epilepsy always carry an emergency supply of medicine with them for friends or family to use if they are with them during a seizure. If a seizure lasts quite long, the medicine can be put inside the person's cheek in the form of a tablet or injected into their rectum through a thin tube in the form of a cream, in order to stop the seizure. Medical professionals can inject medication into one of their veins.

It may be helpful to take note of exactly what happened during the seizure. Careful observations can help doctors later on when they are making a diagnosis.

But many people who have epilepsy recover fully within just a few minutes of having seizures. They can return to work or school without any medical attention.