Witnessing a seizure can be a frightening experience, however, a basic knowledge can enable you to remain calm and provide appropriate first aid.
What are seizures?
In order for the human body to function, billions of electrical nerve impulses are generated and transmitted within the brain in a controlled and co-ordinated way. Seizures occur when there is a sudden random surge of electrical activity within the brain which temporarily disrupts normal function.
Types of seizure
Seizures are classified according to the areas within the brain affected by the chaotic surge of electrical activity. There are 2 main types:
- Partial seizures - the surge of electrical activity is localised to one area of the brain.
- Generalised seizures - the surge of electrical activity within the brain is widespread.
The signs and symptoms a person displays varies according to the type of seizure they are experiencing.
Partial Seizures
During a partial seizure a person may remain alert or may be unaware of their actions or surroundings. Their symptoms may include:
- Altered senses (smell, taste, hearing, speech and vision).
- Intense emotions such as fear, anger, anxiety or panic.
- Feelings of 'deju vu', memory lapses or 'flashbacks'.
- Repetitive movements such as smacking lips, scratching, swallowing, blinking, or facial twitching.
- Jerking, twitching or stiffness of limbs.
- Shouting, swearing or screaming.
- Sexual inhibition.
- Incontinence.
- Nausea, sweating or feeling flushed.
Partial seizures are usually brief and resolve spontaneously. First aid focuses on observing the patient and ensuring their safety until the seizure resolves. The person should not be restrained but should be guided away from dangers, such as traffic, and dangerous objects should be removed from their immediate area.
Generalised Seizures
These are further classified into different types:
- Absence seizures - brief and spontaneous episodes of loss of consciousness. The person appears to be 'daydreaming' and is momentarily unresponsive. Absence seizures can occur frequently, affecting many daily activities. Recovery from absence seizures is usually spontaneous.
- Atonic seizures - (drop attacks) a complete and sudden loss of muscle tone resulting in a fall or collapse. Recovery is usually spontaneous but injuries from falling are common.
- Tonic clonic seizures – (the most widely recognised type of generalised seizure) cause stiffness, thrashing and jerking of the limbs and facial twitching. Breathing is affected resulting in cyanosis (a blue tinge) around the mouth. Loss of consciousness occurs and biting of the tongue/cheek and incontinence of bladder/bowels are common. After the seizure, a 'post ictal' period commonly occurs involving confusion, drowsiness, memory loss and /or headache. Tonic clonic seizures typically last less than 3 minutes.
First Aid for Tonic Clonic Seizures
First aid focuses on ensuring the safety of the person both during and after the seizure.
- Keep calm, reassure people nearby if required.
- Remove dangerous objects from the immediate area (Don't try to move or restrain the person).
- Loosen tight clothing from the neck.
- Put a soft pillow/ folded jumper/coat under the person's head for protection.
- Turn the person onto their side. This opens their airway and allows anything in the mouth to drain out (Don't put anything into the person's mouth).
- Time the seizure.
- Place the person in the recovery position when the seizure stops.
- Stay with the patient until they have regained consciousness and any post ictal symptoms have resolved.
Dial 999 if:
- The seizure lasts more than 3 minutes.
- Repeated seizures occur.
- Breathing is compromised after the seizure has ended.
- Injury has been sustained.
- The person is pregnant.
- You don't know the person and cannot be sure that they are epileptic.
You might also be interested in:
First Response Blog: Dialling 999
Useful links:
National Institute for Health and Clinical Excellence (NICE)
