First Aid Guide: Seizures

First Aid Guides and Checklists

About Seizures

Severe seizures may involve uncontrollable muscle spasms, rigidity, loss of consciousness, loss of bladder and bowel control, and in some cases, breathing that stops temporarily. Many epileptics carry cards or bracelets which identify their condition.

Seizures have a beginning stage (known as prodrome), middle stage (ictal), and end stage (postictal).

Health care professionals typically classify seizures as focal or generalized. If health care professionals don’t know how the seizures began, they may classify the seizures as unknown onset.

Seizure Stages

Prodrome is the earliest warning that a seizure may occur, but it is not part of the seizure itself. During the prodrome, people may feel as though a seizure is coming but cannot describe it, and also may have changes in behavior. This can happen in hours or even days before a seizure. The prodrome stage may include an aura. The aura is the first symptom of a seizure. Symptoms during the aura may include the feeling that a person or place is familiar, known as deja vu, or a feeling that a person or place is not familiar. Or people may simply feel strange, feel fear or panic, or even have pleasant feelings. Symptoms also may include smells, sounds, tastes, blurred vision or racing thoughts. The prodrome may include a headache, numbness or tingling, nausea, or dizziness.

The ictal stage is the actual seizure, but the symptoms and how long it lasts depend on the type. Postictal is recovery after the seizer. The postictal stage can last minutes or hours. Some people recover quickly while others take hours, and depends on the type of seizure and what part of the brain was affected.

Focal Seizures & Symptoms

Focal seizures result from electrical activity in one area of the brain. This type of seizure can occur with or without loss of consciousness. Symptoms of focal seizures may be confused with other conditions of the brain or nervous system. They include migraine, narcolepsy or mental illness.

Impaired Awareness
These seizures involve a change or loss of consciousness or awareness that feels like being in a dream. People having these types of seizures may seem awake but they stare into space and don’t respond to their environment. They may perform repetitive movements such as hand rubbing, mouth movements, repeating certain words or walking in circles. They may not remember the seizure or even know that it occurred.

Unimpaired Awareness
These seizures may alter emotions. They also may change the way things look, smell, feel, taste or sound. But the seizures don’t cause a loss of consciousness. During these types of seizures, people may suddenly feel angry, joyful or sad. Some people have nausea or unusual feelings that are hard to describe. These seizures may result in trouble speaking and involuntary jerking of a body part such as an arm or a leg. They also may cause sudden sensory symptoms such as tingling, dizziness and seeing flashing lights.

Generalized Seizures & Symptoms

Seizures that appear to involve all areas of the brain from the time they start are called generalized seizures. There are different categorized types with different symptoms.

Absences Seizures
Absence seizures, formerly known as petit mal seizures, often occur in children. Absence seizures typically cause a person to stare into space or make subtle body movements such as eye blinking or lip smacking. They usually last for 5 to 10 seconds. These seizures may happen up to hundreds of times a day. They may occur in clusters and can cause a brief loss of awareness.

Tonic Seizures
onic seizures cause stiffening of the muscles. These seizures usually affect muscles in the back, arms and legs. People who experience these seizures may lose consciousness and fall to the ground.

Atonic Seizures
Atonic seizures, also known as drop seizures, cause a loss of muscle control. People having this type of seizure may suddenly fall down or drop their head.

Clonic Seizures
Clonic seizures are associated with repeated jerking muscle movements. These seizures usually affect the neck, face and arms on both sides of the body.

Myoclonic Seizures
Myoclonic seizures usually appear as sudden brief jerks or twitches of the arms and legs. There is often no loss of consciousness.

Tonic-Clonic Seizures.
Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure. They can cause a sudden loss of consciousness, body stiffening and shaking. They sometimes cause people to lose control of their bladder or to bite their tongue. They may last for several minutes. Tonic-clonic seizures also may start as focal seizures that then spread to involve most or all of the brain.

Treatment and First Aid

Do not attempt to restrain a person suffering a seizure and do not put anything in their mouth! Let the seizure play out, but here is what you can do:

  • Seek professional help
  • Move furniture and other objects away from the victim to help prevent injury
  • Loosen their clothing if possible
  • If the victim vomits, gently turn the victim on their side to release fluids
  • Stay nearby and observe the victim if they are concious
  • If the victim looses consciousness and is not breathing, call 9-1-1 and begin CPR if qualified

Seek immediate medical help immediately if any of the following occurs:

  • The seizure lasts more than five minutes
  • The person isn’t breathing after the seizure stops
  • A second seizure follows immediately
  • The seizure is accompanied by a high fever or heat exhaustion
  • The person who had the seizure is pregnant or a diabetic
  • The seizure resulted in a severe injury