Seizure Aid

8/7/2019 Seizure Aid

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What to do when someone has a seizure

epilepsy

rst aid


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A large print text only version of

this leaet is available from the

Epilepsy Helpline on:01494 601 400

(Monday - Friday 10am - 4pm)

rst aidUsually when a person has an epilepticseizure there is no need to call an

ambulance. However you should alwaysdial 999 for an ambulance if:

it is the persons rst seizure;

they have injured themselves badly;

they have trouble breathing after the seizurehas stopped;

one seizure immediately follows another with

no recovery in between;

the seizure lasts two minutes longer than is

usual for them; or the seizure lasts for more than ve minutes

and you do not know how long their seizures

usually last.

These guidelines are particularly relevant for

tonic clonic (convulsive) seizures (see page 8).


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What to do when someone has aseizure

Knowing how to help someone during and

after an epileptic seizure may help you, and

them, feel more condent 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 dont

know about their epilepsy, this leaet 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 passingelectrical signals to each other. In some

people, these signals may suddenly be

interrupted, and this can cause an epileptic

seizure (sometimes called a t 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.

Some people have more than one type

of seizure.

Some people only have seizures when

they are awake.

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Some people have nocturnal seizures.

Nocturnal seizures happen when the

person is sleeping. The name does not

explain what type of seizures they are,

only that they happen when the person is

asleep.

Some people have seizures when they

are awake and when they are asleep.

Most seizures happen suddenly, without

warning, last a short time (a few seconds

or minutes) and stop by themselves.

Injuries can happen during a seizure, but

most people do not hurt themselves and

do not usually need to go to hospitalor see a doctor. (See inside front cover

for details about when to call for an

ambulance).

Types of epileptic seizures and what to doEpileptic 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.See NSE leaet epilepsy - seizures for

more information about seizure types.

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.

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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 a SPS. In a

CPS the persons consciousness is affectedand they may be confused. You might

notice them wandering around or behaving

strangely and they may not know what they

are doing. They may pick objects up for no

reason, ddle with their clothes or makechewing 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.


do not restrain them as this may upset or

confuse them;

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gently guide them away from dangerous

situations (such as walking into the

road); and

speak quietly and calmly so that they are

not startled. They may be confused, so if

you speak loudly or act forcefully this

may confuse them more. They may

mistake your help for being hostile, and

respond in an upset or aggressive way.

After the seizure stops:

they may feel tired and need to sleep;

they may be confused and not fully

aware of their surroundings so it mayhelp to remind them where they are; and

stay with them until they have recovered,

and can safely return to what they were

doing before the seizure.

Some people recover quite quickly after theirseizures, others may take longer to feel

normal again.

Secondarily generalised seizures

For some people SPS and CPS develop intoa 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.

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if they are aware of an aura, they may

need help to make themselves safe

before the generalised seizure starts.

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.


stay with them, and if necessary, gently

guide them away from any danger.

Tonic and atonic seizures

In a tonic seizure the persons muscles

suddenly become stiff. If they are standing

they often fall backwards and may injure the

back of their head. In an atonic seizure

(also called a drop attack) the persons

muscles suddenly relax, and they become

oppy. If they are standing they often fall

forwards and may injure their face or head.

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Tonic and atonic seizures tend to be very

brief and happen without warning. People

usually recover quickly.

What to do after the seizure:

as they recover they may need

reassurance. If they have been injured,

they may need medical help.

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 happeningclose 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 havent hurt themselves.

Tonic clonic (convulsive) seizures

(sometimes called grand mal seizures)

When a person has a tonic clonic seizure

they usually fall to the ground and makeshaking or jerking movements. During the

seizure their breathing might be affected and

they may go pale or blue, especially around

their mouth. They may also bite their tongue.

Although this can be frightening to see,

these seizures are not usually a medical

emergency. Usually, once the jerking has

stopped, the person recovers and their

breathing goes back to normal.

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try to stay calm;

note the time to check how long the

seizure is going on (because there may

be a risk of status - see page 11);

move objects, such as furniture, away

from the person if there is a risk of

injury. Only move the person if they are

in a dangerous place; for example, at the

top of stairs or in the road. See photo 1;

put something soft (like a jacket or

cushion) under their head, or cup their

head in your hands, to stop their headhitting the ground. See photo 2;

do not restrain them, allow the seizure to

happen;

do not put anything in their mouth - there

is no danger of them swallowing theirtongue during the seizure; and

try to stop other people from crowding

around.

photo 1 photo 2


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What to do when the jerking (convulsing)

has stopped (recovery):

roll them on to their side into the

recovery position (see page 15);

wipe away any spit and if their breathingis difcult check their mouth to see that

nothing is blocking their airway, like food;

try to minimise any embarrassment. If

they have wet themselves, deal with this

as privately as possible; and stay with them, giving reassurance, until

they have fully recovered.

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.

Status epilepticus

Most peoples 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 followsanother 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.

Usually when a person has a tonic clonicseizure there is no need to call for an

ambulance. However you should always dial

999 for an ambulance if:

it is their rst seizure;

they have injured themselves badly; they have trouble breathing after the seizure

has stopped;

one seizure immediately follows another with

no recovery in between;

the seizure lasts two minutes longer than

usual for them; or

the seizure last for more than ve minutes

and you do not know how long their seizures

usually last.


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11

Status epilepticus

Most peoples 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 followsanother 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 ofseizure 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 on page 10

for when to call for an ambulance.

Some people who go into status areprescribed a form of emergency (or rescue)

medication called diazepam to stop their

seizures. Sometimes this is given rectally

(into the persons bottom). Carers will need

training on how to give rectal diazepam and itis important to have a written protocol (plan)

for each individual, for the carer to follow.

See NSE leaets epilepsy medication

for adults or epilepsy medication

for children for more information aboutmedication for status.


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How else can I help?

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 provideuseful 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.

Where were they and what were they

doing before the seizure?

Did you notice their mood change - were

they excited, anxious or quiet?

Were there any triggers for the seizure

did they feel tired, hungry or unwell?

Did they have any warning that the

seizure was going to happen?

Did they have any unusual sensations,such as an odd smell or taste?

What made you notice the seizure (a

noise, did they fall or did their eyes roll)?

Did they appear to be blank or stare

into space? Did they lose consciousness or were

they confused?

Did they do anything unusual such as

mumble, wander about or ddle with their

clothing? Did their colour change (become pale or

ushed) and if so, where (face or lips)?

Did their breathing change (e.g. become

noisy, or look difcult)?


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Did any part of their body move, jerk or

twitch?

Did they fall down, or go stiff or oppy?

Did they wet themselves?

Did they bite their tongue or cheek? How long did the seizure last?

What were they like after the seizure?

Did they need to sleep?

How long was it before they were able to

carry on as normal? Did you notice anything else?

What do I need to know about someones

epilepsy?

There are some things it can be useful to

know about someones epilepsy, so you can

help them if they have a seizure.

What types of seizures do they have?

For example, complex partial seizures or

absences.

How long do their seizures normally last?Epileptic seizures usually stop by

themselves. Although the length of

seizures is different from person to

person a seizure usually lasts the same

length of time for each person. How often do they have seizures?

Some people keep a note of when their

seizures happen, in a seizure diary.

Contact NSE for a free seizure diary.

Are their seizures usually triggered orbrought on by anything, such as stress

or tiredness?

Do they have a history of status? If so,

do they need emergency medication?

(See page 11).


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onalS

ocietyforEpilepsyMay20

07

Join NSEs Associate Membership Scheme

to receive regular information about epilepsy.

Please contact the Associate Membership

Co-ordinator on 01494 601 402 for details.

For other information please write to

Epilepsy Information Services

National Society for Epilepsy

Chesham Lane

Chalfont St. Peter

Bucks SL9 0RJTelephone 01494 601 300

Fax 01494 601 337

www.epilepsynse.org.uk

Epilepsy Helpline

01494 601 400Monday - Friday 10am - 4pm

Every effort is made to ensure that all our information is

correct and up to date. Please note that some information

may change after the date of printing. This information is not

intended to be a substitute for medical guidance from your

own doctors. NSE cannot be held responsible for any actions

taken as a result of using NSE information resources.

Registered Charity Number 206186.

Founded in 1892. Patron Her Majesty The Queen.

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