What is a seizure?

Seizures are caused by rapid and uncoordinated electrical firing in the brain. This can cause temporary abnormalities in behaviours, movements (such as alternating stiffening and jerking of the arms and legs), sensations or a loss of consciousness or altered consciousness level.

When should I call an ambulance?

Call triple zero (000) if:

• the seizure continues for more than 5 minutes or a second seizure quickly follows the first
• the person remains unresponsive for more than 5 minutes after a seizure stops
• the person has been injured
• the person has diabetes or is pregnant
• you know, or believe it to be the person's first seizure
• there is food, vomit or fluid in the mouth

How to help someone having a seizure?

Don’t try to restrain the person or stop the jerking. The main thing is to prevent them from injuring themselves. Don’t move the person unless they are in danger. Put something soft under their head, remove any sharp or unstable objects from the area and stay with them.

There is no danger they will swallow their tongue. Don’t put anything in their mouth and make sure there is no fluid or vomit that could choke them.

Time the seizure and keep an eye on their breathing.

Talk to them calmly to reassure them, until they regain consciousness.

When the seizure stops, put them on their side in the recovery position. If they have vomited or have food or fluid in their mouth put them in the recovery position immediately.

If they fall asleep after the seizure don’t disturb them, but keep monitoring their breathing.

Don’t let them have anything to eat or drink until the seizure has completely stopped. If possible, someone should go home with them.

What are the symptoms of a seizure?

Seizures can cause changes in movement, sensation, awareness, thought or behaviour, depending on which part of the brain the seizure affects. Some seizures involve only part of the brain — others involve the whole brain.

Before a seizure you may have an ‘aura’ — a feeling that forewarns a seizure is coming. An aura may involve odd smells, feelings of deja-vu (where you feel you have been here before), tingling, vision disturbances, or fear or joy. This aura is actually the first part of a seizure.

During the seizure, the symptoms experienced depend on the type of seizure. A person may be alert during the seizure, and able to remember it afterwards, or may not remember it at all.

Symptoms of seizures include:

• loss of consciousness during the seizure, or between several seizures
• becoming unresponsive
• in an absence seizure, the person stops concentrating on their activity and stares off into space, becoming unresponsive until the seizure abruptly ends
• becoming vague, disorientated or confused
• numbness or tingling sensations
• excess saliva coming from mouth
• increased heart rate
• hallucinations
• impaired thinking
• eye blinking or eyes rolling upwards

Motor (movement) symptoms can include:

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

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

Febrile seizures in children may last for a few minutes or even go on for an hour, with the child usually losing consciousness. They may appear red or blue in the face and their muscles may jerk or stiffen. These seizures are not harmful to the child.

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

What happens after a seizure?

After a seizure has ended, there is a recovery phase (known as the post-ictal phase) before a person returns to their normal state. During this phase a person may be confused, tired or exhausted, sore or thirsty. They may feel weak, sick or anxious, be injured, have lost control of their bladder or bowel, or have a headache.

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

What types of seizures are there?

Seizures are classified depending on which part of the brain the seizure starts in, whether a person is aware during the seizure or not, and whether there is movement.

Seizures are classified into 3 major groups:

• focal onset
• generalised onset
• unknown onset

Focal onset seizures start in one small region of the brain (the focus) and may spread to other brain areas. They used to be known as partial seizures. A person may be fully aware of what’s happening (focal aware) or their awareness may be affected (focal impaired awareness).

Generalised onset seizures affect both sides of the brain from the start. This may cause a person to lose consciousness. The seizures may be:

• generalised motor seizures — where the person may make stiffening and jerking movements, known as tonic-clonic seizures (previously called grand mal), or have other muscular effects
• generalised non-motor seizures — where the person has changes in awareness, may stare or have repeated movements like lip-smacking or pulling at clothes

Unknown onset seizures are those that haven’t been diagnosed as either focal or generalised in onset because it’s not clear where the seizure started in the brain. This may be because a person was asleep or alone when the seizure started.

Febrile seizures (also known as febrile convulsions) are seizures brought on by fever in young children. They do not cause any long-lasting effects.

What causes seizures?

Seizures can be caused by:

• epilepsy
• head injury
• brain infection
• brain tumours or other medical problems, including stroke
• birth defects
• some prescription medicines

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

• illicit drugs
• excessive alcohol or alcohol withdrawal
• high or extremely low blood sugar
• flashing lights
• lack of sleep
• extreme stress
• high fever (febrile seizures)

Sometimes, no cause or trigger for a seizure will be found.

How are seizures treated?

Most people who have a seizure don’t go on to have any more, but a person with epilepsy has a tendency to have recurrent spontaneous seizures.

See a doctor if you or your child has a seizure for the first time, if there are several seizures, or if the seizures happen more often than usual.

Medication

People diagnosed with epilepsy will normally need medication to control their seizures. These medications are called antiepileptic drugs, and for up to 70 per cent of people their seizures will be controlled with this medication.

Make sure you follow your doctor’s instructions and let them know if you have any side effects from the medication. Do not stop taking the medication suddenly, as this may itself cause seizures. If one antiepileptic drug doesn’t work for you, there are others you can try until you find the best one for you.

Ketogenic diet

For children whose seizures do not respond to medication, a special diet called the ketogenic diet may help with some types of seizures. Your doctor or specialist will be able to advise whether this is suitable for your child.

Surgery

Surgery to remove the brain tissue that is the focus of seizures may be considered for seizures that are resistant to other treatments, and that always happen in the same location of the brain.

Vagus nerve stimulation

Vagus nerve stimulation involves implanting a device like a pacemaker into the chest. The device sends out weak electrical signals to the brain via the vagus nerve. It can be used for epilepsy that doesn’t respond to medication and that can’t be treated with surgery.

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Seizures and safety

By law, a person who has had a seizure must not drive until advised it is safe to do so by their doctor. Adults and children with epilepsy should have regular reviews with their GP or specialist.

Some people with diagnosed medical conditions like epilepsy, wear special pieces of jewellery or identification (for example MedicAlert) that show that they will need special medical care in an emergency.

Special smartwatches and monitors are also available that can detect seizures and send alerts to family members or carers.

People who have seizures should take precautions when swimming, driving or bathing.

Can seizures be prevented?

Some people who have seizures may get warning signs, such as a change in body temperature, visual problems or a strange taste in their mouth for example. If these ‘auras’ occur, try to get to a safe place or position if possible.

Sometimes, other people can tell if someone they know is about to have a seizure. They may look different, their pupils may change size or they may act out of character. Again, if this happens, try to guide the person to a safe location.

Some people can prevent seizures by avoiding their triggers such as:

• flashing or flickering lights
• lack of sleep
• stress
• alcohol
• missing seizure medication doses

As mentioned, medication is effective at treating seizures in 60-70 per cent of people.

Important: Anyone taking prescribed medicines for seizures should always take the correct dosage and make sure they do not miss a dose.