How to Handle a Seizure

Tongue-biting, thrashing limbs, eyes rolled toward the back of the head -- to watch someone with epilepsy have a seizure can be frightening. Still, most seizures aren't an emergency. They stop on their own with no permanent damage.

There isn’t much you can do to stop a seizure once it starts. But you can help protect someone from harm during one.

It's worth knowing some basic first aid -- and when it's time to call 911.

Types of Seizures

Some are more dangerous than others.

Focal seizures start in one part of the brain. The person with epilepsy may not be aware of what's happening. Her arm might start to move or her face start to twitch. And even though she's awake and could be aware, she can't control it. She might seem to zone out or stare at nothing as the seizure becomes complex. When it's over, she won’t remember a thing.

Generalized seizures involve both sides of the brain at once. People are rarely aware of what's happening. The most well-known type falls in this group -- the generalized tonic-clonic seizure, better known as a grand mal seizure. These are frightening to watch and can be an emergency.

These seizures have a set sequence of events:

  1. The person may become unresponsive. She won't answer if you call. She won’t react if you wave a hand in her face or shake her. She may collapse.
  2. Her muscles clench and they become as rigid as a board. This is the tonic phase. It lasts a few seconds.
  3. Next comes a series of jerking movements. This is the clonic phase. It can last a few seconds or several minutes.
  4. Eventually, the jerking stops and she regains consciousness. She may be confused or disoriented for a little while.

Any generalized seizure can be dangerous because the person is unaware of the surroundings and can't protect herself from harm. The uncontrolled thrashing raises the chances of injury. This type is most likely to result in a trip to the emergency room.

First Aid

It's all about taking precautions. You’re most likely to need it for a generalized tonic-clonic seizure.

  • Keep other people out of the way.
  • Clear hard or sharp objects away.
  • Don't try to hold your friend down or stop her movements.
  • Place her on her side, to help keep her airway clear.
  • Look at your watch at the start of the seizure, so you can time its length.
  • Don't put anything in your friend's mouth. Contrary to a popular myth, you can’t swallow your tongue during a seizure. But if you put an object in her mouth, she could damage her teeth or bite you.

Remember, this type probably isn’t an emergency, although it may look like one. Milder seizures -- like a bit of staring or shaking of the arms or legs -- aren’t emergencies either. Still, you should gently guide the person away from threats, like traffic or stairs.

WebMD Medical Reference Reviewed by Richard Senelick, MD on July 14, 2017



Epilepsy Foundation: "First Aid."

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