Tongue-biting, thrashing limbs, eyes rolled in the back of the head -- witnessing someone with epilepsy having a convulsive seizure can be truly frightening. But most seizures aren't an emergency; they stop on their own, with no permanent ill effects.
There is little you can do to stop a seizure once it has started. But by learning a few tips, you can protect a person with epilepsy from harm during seizures. It's worth knowing some basic first aid for seizures -- and when it's time to call 911.
To diagnose epilepsy, your doctor will take a detailed medical history (including a family history of seizures), gather information about your behavior before, during, and after the episode, and do a physical exam. Make sure someone who witnessed the seizure goes to the doctor with you.
An electroencephalogram (EEG) -- a brain wave study -- can reveal abnormal brain waves characteristic of epilepsy and sleep deprivation. Keeping someone awake for 24 hours increases the chances of finding abnormalities...
Some seizures are more dangerous than others. The two main types are partial seizures and generalized seizures.
Partial seizures start in a single part of the brain. During simple partial seizures, a person with epilepsy is aware of what's happening. For example, a person's arm might start moving, or her face start twitching -- the person is awake and aware, but can't control it. This can be followed by decreased consciousness or staring as the seizure becomes complex. After the seizure, the person has no recollection of the event.
Generalized seizures involve both sides of the brain at once. People are rarely aware of what's happening during generalized seizures.
Convulsive seizures are known as generalized tonic-clonic seizures (grand mal seizures). These are the most frightening seizures to watch, and can be an emergency. In a generalized tonic-clonic seizure, this is the sequence of events:
The person may become unresponsive. Calling out to them brings no answer; waving your hand in their eyes or shaking them elicits no response. He may suddenly collapse.
The person's muscles clench and he or she becomes rigid as a board (the ''tonic'' phase). This lasts a few seconds.
Next, a series of jerking movements convulse the person's body (the ''clonic'' phase). The convulsions of a seizure can last for only seconds, or can go on for minutes.
Eventually, the jerking stops and the person regains consciousness. Usually after a generalized seizure, a person is confused or disoriented for a short period of time.
Any generalized seizure can be dangerous, because the person becomes unaware of his surroundings and can't protect himself from harm, such as while driving. The uncontrollable thrashing movements during a generalized tonic-clonic seizure increase the risk of injury. Most seizures that result in trips to the emergency room are of this type.