What is a seizure?

Seizures happen when there are sudden and uncontrolled changes to electrical signals in the brain.

This can cause short-term changes in:

• behaviours
• feelings
• movements (such as sudden stiffening or jerking of arms and legs)
• loss or change of awareness

The type of seizure you have depends on:

• the part of the brain the seizure starts in
• if you are aware during the seizure
• if there is a change in your movements during the seizure

Seizures are divided into 3 major groups based on where they start in the brain.

Focal onset

Focal onset seizures start in one small area of your brain (the 'focus') and can spread to other areas. They used to be known as partial seizures. You may be fully aware of what's happening ('focal aware') or your awareness may be affected ('focal impaired awareness').

Generalised onset

Generalised onset seizures affect both sides of your brain from the start. This may cause you to lose consciousness ('black out'). The seizures may be:

• generalised motor seizures — cause stiffening and jerking movements, known as tonic-clonic seizures (previously called 'grand mal')
• generalised non-motor seizures — cause changes in awareness, you may stare or have repeated movements like lip-smacking or pulling at your clothes

Unknown onset

Unknown onset seizures are those where it is not clear where in your brain it started. Your unknown onset seizure type might change with more testing or information.

What is a febrile seizure?

Febrile seizures or febrile convulsions, are seizures that happen in children when their body temperature rises due to a fever. About 1 in 30 children will have a febrile seizure and usually only once. They usually happen between 6 months and 6 years old.

Even though it can be scary to watch, your child usually won’t have any ongoing problems from a febrile seizure. Medicine for fevers won’t stop a febrile seizure, but can help your child feel more comfortable when they are sick.

First aid advice for febrile convulsions is available from The Royal Children’s Hospital Melbourne.

If the seizure was less than 5 minutes long and your child was very unwell beforehand, see a doctor immediately — go to your nearest hospital emergency department if you can't see your GP or paediatrician (child specialist) right away.

If it isn’t their first seizure and it lasted under 5 minutes, see your doctor as soon as you can.

Febrile seizures are not usually harmful for the child in the long term.

What is a tonic-clonic seizure or 'grand mal'?

Tonic-clonic (‘grand mal’) seizures are generalised seizures that cause a sudden loss of consciousness. Usually, the person falls to the ground followed by stiffening (tonic) and jerking (clonic) of the muscles. This usually lasts a couple of minutes.

What is an absence seizure or ‘petit mal’?

Someone having an absence seizure (‘petit mal’) will stop what they are doing and lose consciousness for 5-30 seconds. They will have a blank stare with blinking, mouthing or chewing movements.

What are the symptoms of a seizure?

You may have a warning feeling ('aura') or focal aware seizure, which is the feeling before a seizure happens. An aura may involve:

• odd smells
• feeling of déjà vu (feeling like you have been in the situation before)
• tingling
• changes in vision
• feelings of fear or joy

This aura is actually the first part of a seizure.

Seizure symptoms depend on the seizure type. You may be alert during the seizure and remember it afterwards, or not remember it at all.

Symptoms of seizures include:

• change of consciousness (awareness) during the seizure, or between seizures
• becoming unresponsive
• staring into space
• becoming vague, disorientated or confused
• numbness or tingling sensations
• hallucinations (seeing, hearing or feeling things that are not there)
• problems with thinking

Motor (movement) symptoms can include:

• stiffening movements ('tonic' phase) — this may make you fall down
• jerking movements ('clonic' phase)
• switching between stiffening and jerking ('tonic-clonic')
• floppiness and loss of muscle tone ('atonic') — this can cause a person to fall
• tremor or shaking or strange postures
• sudden nod of the head
• repetitive movements, such as lip smacking or chewing

Other symptoms include:

• excess saliva coming from your mouth
• a raised heart rate
• eye blinking or your eyes rolling upwards

Most seizures last for less than 2 or 3 minutes and will stop on their own, without any treatment.

After a seizure has ended, there is a recovery phase ('post-ictal' phase) before you return to your normal state. During this phase you may be confused, tired, sore or thirsty.

You may also have the following symptoms:

• feeling weak
• feel sick or anxious
• you may be injured
• loss of control of your bladder or bowel
• a headache

You may or may not remember the seizure. It may take hours or days to get back to normal.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

When should I call an ambulance or go to the emergency department?

Call triple zero (000) if:

• a seizure continues for more than 5 minutes
• a second seizure quickly follows the first
• the person doesn't respond for more than 5 minutes after a seizure stops
• the person has been injured
• the person is swimming or in water at the time of the seizure
• the person has diabetes or is pregnant
• you know, or think it’s the person's first seizure

What should I do while waiting for the ambulance?

If someone near you has a seizure, there are a few things you can do after calling for help.

• Stay with them during the seizure, until it is over.
• Roll them into the recovery position during the seizure if safe to do so — this is in case they vomit, as they could be at risk of choking.
• Put something soft under their head and shoulders.
• Remove any sharp or unstable objects from the area.
• Notice how long the seizure lasts and watch their breathing, to inform the emergency responder.

If someone near you has a seizure, there are also some things you shouldn’t do.

• Don't try to hold the person down, or stop the jerking
• Don't move the person unless they are in danger.
• Don't put anything in their mouth.

After the seizure is finished you should do the following:

• If not already done, and it’s safe to do so, put them into the recovery position.
• Talk to them calmly to reassure them, until they regain consciousness (are fully awake and aware of what's going on).
• If they fall asleep after the seizure don't wake them but watch their breathing.
• Don't let them eat or drink until the seizure has completely stopped.

What causes seizures?

Seizures can be caused by:

• epilepsy
• head injury
• brain infection
• stroke or brain bleeds
• birth defects, birth trauma and genetic factors
• some prescription medicines
• brain tumours and other medical conditions that affect your brain

For people who have epileptic seizures, there may be some things that are likely to trigger a seizure. Common seizure triggers include:

• recreational drugs, alcohol, caffeine and energy drinks
• dehydration or not eating for a long time
• hormone level changes in females
• flashing lights
• lack of sleep
• extreme stress
• being sick, even without a fever

It’s important to take medicines for seizures exactly as your doctor prescribes. Don't skip a dose or stop taking a medicine without first checking with your doctor. If your doctor is not available, check with a pharmacist. To find a pharmacist near you that's open now, use the healthdirect Service Finder tool.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is a seizure diagnosed?

Speak to your doctor if you think you or your child has had a seizure. You will likely be referred to a specialist paediatrician or neurologist for tests. The tests may include an electroencephalogram (EEG) to measure brain activity and an MRI to take a picture of the brain.

If your child is taken to the emergency room after their first seizure, they may have a blood test.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How are seizures treated?

Medicines are the usual treatment for epilepsy, however there are other options that your doctor may recommend.

Medicines

If you’re diagnosed with epilepsy, you will usually be prescribed medicines to control your seizures. Antiepileptic drugs will help most people with epilepsy manage their seizures.

Make sure to follow your doctor's instructions and tell them if you have any side effects from the medicine. Do not stop taking the medicine suddenly, because this could cause seizures. If one medicine doesn't help you, your doctor may add another one or change medicines. You can try different medicines with your doctor’s help until you find the best one for you.

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Ketogenic diet

If your seizures don’t get better with medicine, you can try the ketogenic diet to help with seizures. The ketogenic diet includes high fat and low carbohydrate foods. Your doctor or specialist can advise you if this is an option for you or your child.

Surgery

A neurosurgeon can take out a small piece of brain tissue in the area that the seizures start from. You might consider this if your seizures don’t improve with other treatments and always happen in the same brain area. You will usually still need to take medicine after the surgery.

Vagus nerve stimulation

Vagus nerve stimulation involves putting a small device into your chest wall (similar to a pacemaker). The device sends electrical signals to your brain through the vagus nerve. This can reduce how many seizures you have and make them less severe. Your doctor might recommend vagus nerve stimulation if your seizures don't get better with medicine and can't be treated with surgery.

LOOKING FOR A MEDICINE? — To search by brand name or active ingredient, use the Medicines information search feature.

What are the complications of a seizure?

The chance of complications goes up if you have frequent seizures. It’s uncommon, but a person with epilepsy may die suddenly with no obvious cause of death.

The factors that increase the chances of death are:

• being a young adult
• having tonic-clonic seizures
• having seizures at night
• sudden changes of medicines in people whose seizures are not controlled

By law, if you have had a seizure, you must not drive until your doctor tells you it is safe. If you have epilepsy, you should have regular reviews with your doctor or specialist. Your doctor will notify the authorities and recommend if you are fit to drive. However, the driving licence authority makes the final decision.

If you or your child have had a seizure, be careful when swimming, driving or bathing. Visit Epilepsy Australia's fact sheet on living with epilepsy.

Can seizures be prevented?

The best way to prevent seizures is to follow your doctor's advice and to take your medicine as prescribed. Don't skip doses or stop taking your medicine without first checking with your doctor. Ask your doctor for advice on how to avoid triggers.

Some people with epilepsy wear medical identification jewellery like wristbands to inform others. This helps make sure that you get the right help in an emergency.

Special smartwatches, monitors and apps can detect a seizure and send alerts to family members or carers.

Resources and support

You can call the National Epilepsy Support Service on 1300 761 487 on Monday to Saturday, 9am to 7pm. The Epilepsy Foundation also provides education and services for people with epilepsy.

Learn more about seizures in children by reading the Royal Children's Hospital Melbourne fact sheet Seizures — safety issues and how to help.

For advice on children up to 5 years old, call or visit Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available from 7 am to midnight (AET), 7 days a week (including public holidays).

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

Epilepsy Action Australia have factsheets on epilepsy translated into Arabic and Chinese.