First Aid : Information on First Aid

Are all epileptic seizures the same
What to do during the seizure
What to do after the seizure
How to put someone into the recovery position
it is the person’s first seizure
Types of epileptic seizures and what to do

What to do when someone has a seizure

Usually when a person has an epileptic seizure there is no need to call an ambulance. However you should always dial 999 for an ambulance if:

These guidelines are particularly relevant for tonic clonic (convulsive) seizures.

Knowing how to help someone during and after an epileptic seizure may help you, and them, feel more confident if a seizure happens. How you can help the person may depend on the type of seizures they have. If you know the person, they may have told you about their epilepsy and how you can help them if they have a seizure. If you don’t know about their epilepsy, this leaflet gives you some general guidance on how you can help if they have a seizure.

Epileptic seizures

The brain is made up of millions of nerve cells which control the way we think, move and feel. The nerve cells do this by passing electrical signals to each other. In some people, these signals may suddenly be interrupted, and this can cause an epileptic seizure (sometimes called a ‘fit’ or ‘attack’).

Are all epileptic seizures the same?

There are many different kinds of epileptic seizure. How epilepsy affects one person can be different to how it affects someone else.

Types of epileptic seizures and what to do

Epileptic seizures can be divided into two main types: partial seizures and generalised seizures. Seizures can vary from one person to another and how people are affected and how they recover after seizures also varies.

Partial seizures

In partial seizures the seizure starts in, and affects, just part of the brain. What happens during the seizure depends on where in the brain the seizure happens and what this part of the brain does.

Simple partial seizures In a simple partial seizure (SPS) the person is conscious (awake) and aware of what is happening to them. A SPS could be twitching of one limb or part of a limb, an unusual smell or taste, a strange feeling such as a ‘rising’ sensation in the stomach or ‘pins and needles’ in part of the body or a sudden intense feeling of fear or joy.

What to do during the seizure:

although the person is awake and aware, SPS can feel unsettling so giving gentle reassurance may be helpful.

Complex partial seizures

A complex partial seizure (CPS) affects a bigger part of the brain than SPS. In a CPS the person’s consciousness is affected and they may be confused. You might notice them wandering around or behaving strangely and they may not understand what they are doing. They may pick objects up for no reason, fiddle with their clothes or make chewing movements with their mouth. Afterwards, they may need to sleep; or they might be confused for some time. CPS may last from a few seconds to a few minutes.

What to do during the seizure:

After the seizure stops:

Secondarily generalised seizures

For some people SPS and CPS develop into a generalised seizure (see below). When this happens the person becomes unconscious and will usually have a tonic clonic seizure. This is called a secondarily generalised seizure because it starts as a partial seizure and then becomes generalised. Some people call their partial seizure an ‘aura’ or ‘warning’ because it warns them that a generalised seizure may follow.

What to do during the seizure:

Generalised seizures

Generalised seizures affect all of the brain at once. The person becomes unconscious and afterwards will not remember what happened during the seizure.

Absences (sometimes called petit mal)

During an absence a person becomes unconscious for a short amount of time, usually a few seconds. They may look blank and not respond to what is happening around them. For example, if they are walking they may continue to walk, but will not be aware of what they are doing during the absence.

What to do during the seizure:

Tonic and atonic seizures

In a tonic seizure the person’s muscles suddenly become stiff. If they are standing they often fall backwards and may injure the back of their head. In an atonic seizure (sometimes called a drop attack) the person’s muscles suddenly relax, and they become floppy. If they are standing they often fall forwards and may injure their head. Tonic and atonic seizures tend to be very brief and happen without warning. People usually recover quickly.

What to do after the seizure:

Myoclonic seizures

Myoclonic seizures involve the jerking of a limb or part of a limb. They are brief and can happen in clusters with many happening close together in time. They often happen shortly after waking up from sleep. As they are so brief, there is nothing that needs to be done to help the person other than making sure they haven’t hurt themselves.

Tonic clonic (convulsive) seizures (sometimes called grand mal seizures)

When a person has a convulsive seizure they usually fall to the ground and make shaking or jerking movements. During the seizure their breathing might be affected and they may go blue, especially around their mouth. They may also bite their tongue.

Although this can be frightening to watch, these seizures are not usually a medical emergency. Usually, once the jerking has stopped, the person recovers and their breathing goes back to normal.

What to do during the seizure:

What to do when the jerking (convulsing) has stopped (recovery):

Some people recover quickly after these seizures but more often the person will be very tired, may want to sleep and may not feel ‘back to normal’ for several hours or sometimes days.

How to put someone into the recovery position(when they are lying on the floor)

These guidelines are particularly relevant for tonic clonic (convulsive) seizures.

Status epilepticus

Most people's seizures last the same length of time each time they happen, and usually stop by themselves. However, sometimes seizures do not stop, or one seizure follows another without the person recovering in between. When a seizure goes on for 30 minutes or more it is called status epilepticus, or 'status' for short.

Status can occur in any type of seizure and the person may need to see a doctor. However, status in a tonic clonic (convulsive) seizure is a medical emergency. It is important to call for an ambulance before the seizure goes on too long. Do not wait until it has lasted 30 minutes before calling for help. See the information box above for when to call for an ambulance.

Some people who go into status are prescribed a form of emergency (or rescue) medication called diazepam to stop their seizures. Carers will need training on how to give rectal diazepam and it is important to have a written protocol for each individual, for the carer to follow.
For more information about medication for status,

How else can I help? - recording information about seizures

Because people are often not fully aware during their seizures they might not know what happens to them. Other people who have seen the seizures can often provide useful information for the GP or neurologist. An ‘eyewitness description’ like this may help to diagnose and identify what type of seizures a person is having.

If you see someone having a seizure, it can be helpful to note the following things.

What do I need to know about someone's epilepsy?

There are some things it can be useful to know about someone's epilepsy, so you can help them if they have a seizure.

ID cards and medical jewellery

ID cards and medical jewellery Some people with epilepsy wear or carry something that says they have epilepsy, such as an identity (ID) card or a bracelet or necklace. If they have a seizure the information carried on the ID card or jewellery lets other people know what is happening and how to help.

Training in first aid for epilepsy

The video 'Epileptic Seizures' contains footage of seizures and information about first aid. It is ideal for training purposes. Order it in the online shop.

Training is available from the NSE on epilepsy awareness, including management of seizures.
Information on NSE training services

UK Epilepsy Helpline: 01494 601400
Monday - Friday 10am - 4pm
© The National Society for Epilepsy
May 2007