An epileptic seizure is a sudden and uncontrolled electrical disturbance in the central nervous system that results in a variety of behaviors, movements, or levels of consciousness. Seizures vary greatly in severity and duration and are caused by a variety of factors. Epilepsy is a disease that may cause seizures.
Epilepsy is a brain disorder sometimes called “epilepsy” because the main symptom of epilepsy is seizures. The CDC estimates that 3 million adults and 470,000 children nationwide have epilepsy.1
This means that more than 3.4 million people nationwide are at risk of experiencing a seizure, for which epilepsy is just one factor. Epilepsy is a chronic disease, and some experts estimate that at least 1 million people in the United States have uncontrollable epilepsy, also known as drug-resistant epilepsy.2
According to the U.S. Census Bureau,3 In 2020, there were 258.3 million adults in the United States. To help you know what to do in this situation, let’s learn how to recognize what a seizure looks like and how to help if you’re a bystander. Since epilepsy is not the only reason a person may have a seizure, let’s start with some of the physiological changes that may trigger a seizure.
What triggers a seizure?
Epilepsy is a general term that refers to a group of neurological disorders characterized by recurring seizures. People may be diagnosed with epilepsy as children or adults, and while the exact cause is not entirely known, generally speaking, it is caused by abnormal nerve signaling in the brain.4
Some underlying medical conditions can cause “acquired epilepsy,” which means you develop the disorder as an adult or after a medical condition or injury. Causes of acquired epilepsy include head trauma, infectious diseases, stroke, and tumors. Structural abnormalities in the brain may also trigger recurrent seizures.
According to “Cure Epilepsy”,5 Up to 50% of the world’s epilepsy patients have idiopathic epilepsy, meaning the exact cause cannot be determined. More than 150,000 people are diagnosed with epilepsy every year. This means it affects more people than cerebral palsy, Parkinson’s disease, multiple sclerosis and amyotrophic lateral sclerosis combined.
According to the Centers for Disease Control,6 It is estimated that the number of people with active epilepsy is not uniform across the United States. , Pennsylvania and New York.
Not everyone who has a seizure has epilepsy. Almost anything that disrupts neural communication can also cause a seizure. For example, a high fever may cause a febrile seizure. high blood sugar,7 Seizures may also be triggered by sleep deprivation, low blood sodium levels, legal or illegal drugs (such as amphetamines or cocaine), severe alcohol intoxication, or withdrawal from alcohol and drugs.8
Different types of epileptic seizures have different symptoms
The brain is an extremely complex organ, and when neural connections are disrupted, symptoms can vary. Types of epileptic seizures are divided into localized seizures and generalized seizures, and each type of seizure has subcategories. Generally speaking, symptoms or warning signs of a seizure may include:9,10
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Stare into space |
Stiffness in the body and limbs |
Twitching movements in the arms and legs |
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breathing problems |
loss of consciousness |
Loss of bowel and bladder control |
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No response to noise or speech |
seem confused |
Nodding rhythmically |
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periods of staring and rapid blinking |
Cognitive or emotional changes, such as fear and anxiety |
Focal seizures, which affect a certain area of the brain, were once called focal epileptic seizures.11 A person may experience focal seizures with or without loss of consciousness. During a simple focal seizure, symptoms appear in areas of the brain affected by dysfunctional electrical impulses. Typically, these affected muscle movements are limited to one or two adjacent muscle groups.
During a complex partial seizure, a person loses consciousness, but they appear conscious and awake. The person may not pass out, but they have no idea what is going on around them. People with complex focal epilepsy often exhibit unusual behaviors such as smacking their lips, crying, laughing, or screaming.
Seizures may also involve large areas of the brain, which are called generalized seizures.12 There are many types of generalized seizures, but the most widely known are tonic-clonic seizures, formerly known as epileptic seizures. These are the types that often appear in movies or television.13
The symptoms of tonic-clonic seizures are severe, but they are not the most common type of epilepsy. Tonic-clonic seizures cause sudden loss of consciousness and bladder control, along with muscle stiffness and repeated twitching.
Two other types of generalized seizures also involve muscle groups. An atonic seizure causes a person to lose muscle control and suddenly collapse to the ground. Falls or falls can result in other serious injuries, especially when people hit their heads or hit sharp or hard objects. Myoclonic seizures cause brief jerking or twitching of the arms and legs but usually do not result in loss of consciousness.
Finally, you may observe absence seizures that were once known as petit mal seizures. These seizures most commonly occur in children. You may notice the person staring into space or making subtle body movements. These types of seizures can last up to 10 seconds and can occur hundreds of times a day to a person.
Three stages of epileptic seizures
There are three distinct stages of epileptic seizures. The first phase is called the prodromal phase, where you experience warning signs that a seizure may be imminent. For some people, these symptoms may occur hours or days before a seizure occurs. Prodromal symptoms may include:14
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a feeling of impending doom or fear |
A similar sound or tone of voice every time before an epileptic seizure occurs |
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Difficulty finding words or forming clear thoughts |
The feeling of a bow in your stomach |
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Hear sounds like you’re underwater |
It feels like you’re in Alice in Wonderland and you feel small while everything else is huge or vice versa |
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A feeling of déjà vu, where everything is familiar, or on the contrary – everything is unrecognizable |
The prodromal phase is the first stage of epileptic seizures.15 Once an epileptic seizure occurs, the patient is in the ictal phase. The ictal phase begins with the first symptoms of a seizure and ends with the end of visible seizure activity. The length of time and symptoms you see depend on the type of seizure.
The final stage of an epileptic seizure is called the postictal phase. This may last for minutes or hours and also depends on the type of seizure, the area of the brain affected and the duration of the seizure. In the post-ictal phase, people often feel groggy, have trouble remembering, have muscle aches, and have trouble speaking or writing. Some people experience nausea, headaches, or may lose bladder control.
How to help if you are a bystander
If you recognize the signs and symptoms of someone having a seizure, your first goal is to keep that person safe. Seizure-related injuries can occur when a person falls to the ground or is repeatedly jerked or hits their head on a hard object.16 The best way is to help them get there. Don’t try to get them to stand or sit in a chair.
Once they are on the floor, place something soft under their head so that if their neck makes a twitching motion, they don’t bang their head on the floor. Don’t put anything in their mouth because the tongue won’t be able to swallow. It is important not to restrict their arms or legs, as muscle contraction may cause bone or muscle damage if their limbs are restrained.
There’s nothing you can do to stop a seizure, so don’t yell at them or try any other techniques. It is important to track the duration of a patient’s seizures. If the seizure lasts longer than five minutes or the person begins to have consecutive seizures, call 911 or emergency services in your area. Although these conditions are rare, they can be life-threatening.
Other situations that also require emergency services include when a patient has a seizure in the water, has difficulty breathing, or is pregnant. You should also call emergency services if you learn this is their first seizure.
When they convulse violently, they may breathe intermittently. If you can safely roll them to one side when they twitch, place them in the recovery position. If you can’t roll them safely, wait until they stop twitching and then roll them into the recovery position.
The recovery position gives the body the best chance of keeping the airway open and any vomitus expelled from the mouth by gravity.number 17 If the person wears glasses, take them off first.
Do not roll them onto their front as this will put extra weight on their lungs and make breathing more difficult. Only move the person to a recovery position yourself if you believe there is no spinal injury. Start by kneeling next to them. Hold the arm closest to you at right angles to your body, elbow bent, palm facing up. Place your other hand on their body and place it on the side of their cheek close to yours.
Place your hands on your cheeks while pulling your other leg up so your feet are flat on the floor. Then, press the back of their hand against their cheek and pull the other leg so their body rolls toward you and sideways. At this time, you can adjust your legs and arms so that they are bent at right angles, tilt your head back slightly, and lift your chin to keep the airway open.
They are awake and alert – now what?
Once the patient begins to gradually recover and wake up, they can remain in the recovery position until they are ready to sit on the floor in a safe space. They should not be allowed to leave or eat or drink until they are fully awake and alert. Stay with them until they fully realize what is going on and you can tell them what is going on.18
If you learn this is their first seizure, call emergency services so they can be fully evaluated in hospital. While this may be the first idiopathic seizure, it may also be the first symptom of a minor stroke, brain infection, growth abnormality, or injury from a blow to the head within the past hours or days.
Witnessing a seizure may be overwhelming at first, but when you know what to do, you can help prevent further harm and ensure emergency services can see the patient if needed.