Health Library SeizuresFrom Healthwise

The brain controls how the body moves by sending out small electrical signals through the nerves to the muscles. Seizures, or convulsions, occur when abnormal signals from the brain change the way the body functions.

Seizures are different from person to person. Some people have only slight shaking of a hand and do not lose consciousness. Other people may become unconscious and have violent shaking of the entire body.

Shaking of the body, either mild or violent, does not always occur with seizures. Some people who have seizures briefly lose touch with their surroundings and appear to stare into space. Although the person is awake, he or she does not respond normally. Afterwards, the person does not remember the episode.

Not all body shaking is caused by seizures. Many medical conditions can cause a type of body shaking that usually affects the hands and head (tremors).

A small number of people will have only one seizure during their lifetime. A single seizure usually lasts less than 3 minutes and is not followed by a second seizure. Any normally healthy person can have a single seizure under certain conditions. For instance, a sharp blow to the head may cause a seizure. Having one seizure does not always mean that a serious health problem exists. But if you have a first-time seizure, you should be checked by your doctor. It is important to rule out a serious illness that may have caused the seizure. Fever seizures (febrile convulsions) are the most common cause of a single seizure, especially in children. For more information, see the topic Fever Seizures.

Causes of seizures

Epilepsy is a nervous system problem that causes seizures. It can develop at any age. About 2.5 million Americans have epilepsy. For more information, see the topic Epilepsy.

A seizure can be a symptom of another health problem, such as:

• A rapidly increasing fever (fever seizure).
• An extremely low blood sugar level in a person who has diabetes.
• Damage to the brain from a stroke, brain surgery, or a head injury.
• Problems that have been present since birth (congenital problems).
• Withdrawal from alcohol, prescription medicine, or illegal drugs.
• An infection, such as meningitis or encephalitis.
• A brain tumor or structural defect in the brain, such as an aneurysm.
• Parasitic infections, such as tapeworm or toxoplasmosis.

Eclampsia is pregnancy-related seizure activity that is usually caused by high blood pressure. It is a life-threatening condition for both a mother and her baby (fetus) because during a seizure, the fetus's oxygen supply is drastically reduced. Eclampsia is more likely to occur after the 20th week of pregnancy. For more information, see the topic Preeclampsia and High Blood Pressure During Pregnancy.

Nonepileptic seizure (NES), also called pseudoseizure, is a condition that can cause seizure-like activity. NES is characterized by a loss of or change in physical function without a central nervous system problem. The loss or change causes periods of physical activity or inactivity that resemble epileptic seizures. NES is usually related to a mental health problem. The physical symptoms may be caused by emotional conflicts or stress. The symptoms usually appear suddenly and at times of extreme emotional stress.

Protect a person during a seizure

No matter what caused the seizure, you can take steps to protect a person during a seizure and to get help after the seizure.

• During a seizure:
  • Protect the person from injury.
    • Keep him or her from falling if you can, or try to guide the person gently to the floor.
    • Try to move furniture or other objects that might injure the person during the seizure.
    • If the person is having a seizure and is on the ground when you arrive, put something soft under his or her head.
  • Do not force anything, including your fingers, into the person's mouth. Putting something in the person's mouth may cause injuries to him or her, such as chipped teeth or a fractured jaw. You could also get bitten.
  • Turn the person onto his or her side, with the mouth down, unless the person resists being moved.
  • Do not try to hold down or move the person.
  • Try to stay calm.
  • If the person vomits, turn the person onto his or her side.
  • Pay close attention to what the person is doing so that you can describe the seizure to rescue personnel or doctors.
    • What kind of body movement occurred?
    • How long did the seizure last?
    • How did the person act immediately after the seizure?
    • Are there any injuries from the seizure?
  • Time the length of the seizure, if possible.
• After a seizure:
  • Check the person for injuries.
  • If you could not turn the person onto his or her side during the seizure, do so when the seizure ends and the person is more relaxed.
  • If the person is having trouble breathing, use your finger to gently clear his or her mouth of any vomit or saliva.
  • Loosen tight clothing around the person's neck and waist.
  • Provide a safe area where the person can rest.
  • Do not give anything to eat or drink until the person is fully awake and alert.
  • Stay with the person until he or she is awake and familiar with the surroundings. Most people will be sleepy or confused after a seizure.

A person who has had a seizure should not drive, swim, climb ladders, or operate machinery until he or she has seen a doctor about the seizure.

Treatment

Treatment of a seizure depends on what has caused the seizure.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

• Breathing stops for longer than 30 seconds. After calling 911 or other emergency services, see the topic Dealing With Emergencies.
• The seizure lasts longer than 3 minutes.
• Signs of a serious illness are present, such as:
  • Fever or shaking chills.
  • Severe headache with stiff neck, confusion, or irritability.
  • Very rapid, difficult breathing.
  • New, tiny purple or red spots (petechiae) on the skin or in the mouth.
  • Sudden increase in the number of bruises and how severe they are (purpura).
• More than one seizure occurs within 24 hours, even in a person who has a history of epilepsy.
• The person is still not responding normally 1 hour after the seizure and is:
  • Not fully awake.
  • Confused.
  • Sick to his or her stomach (nauseated) or vomiting.
  • Dizzy.
  • Unable to stand or walk.
• A seizure occurs after a sudden, severe headache.
• A seizure occurs with symptoms of a stroke. Symptoms of a stroke include:
  • Inability to move (paralysis) a part or all of one side of the body (such as the face, arm, or leg) or persistent numbness.
  • Loss of vision in one or both eyes.
  • Confusion or altered behavior, such as unusually aggressive or combative behavior.
  • Inability to speak, difficulty speaking, or difficulty understanding speech.
  • Severe dizziness (vertigo) and vomiting.
• A seizure occurs after a head injury.
• A pregnant woman has a seizure.
• A person with diabetes has a seizure.
• A seizure occurs after eating or breathing poison.
• A seizure occurs after using an illegal drug.
• A seizure occurs after drinking a large amount of alcohol (alcohol poisoning).

Note:

For information about how to help a seizure victim, see protecting a person from harm during a seizure.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

	Yes	Was this your first seizure?
When to See a Doctor See significance of a first seizure if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Did the seizure last less than 3 minutes and you have not had a second seizure? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think your seizure was caused by a medicine?
When to See a Doctor See significance of medicines and seizures if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you think your seizure was caused by a medicine? If your answer is Yes: Do not take the next dose of medicine until you have talked with the doctor who prescribed it. If you are taking a medicine that was not prescribed by a doctor, stop taking it. Call your doctor. Call your health professional today if you answer "Yes" to any of the following questions. Note: If you are being treated for epilepsy, be sure to follow your treatment plan. Taking too little or too much of your medicine, abruptly stopping your medicine, or changing your medicine schedule can cause seizures and other health problems. Yes Has the pattern of your seizures changed since you stopped taking a medicine? Yes Has the pattern of your seizures changed since you started taking a medicine? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think that your seizure was caused by withdrawal from alcohol or a medicine, including an illegal drug?
When to See a Doctor See significance of withdrawal symptoms if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you think your seizure was caused by alcohol withdrawal? Yes Do you think your seizure was caused by withdrawal from a medicine, including an illegal drug? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have epilepsy?
When to See a Doctor See significance of epilepsy if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Have you had a seizure that lasted less than 3 minutes? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had an increase in the number of your seizures? Yes Have you had a change in what happens during or after your seizures? Yes Has the pattern of your seizures changed since you started taking a medicine? Yes Has the pattern of your seizures changed since you changed the dose of a medicine? Yes Has the pattern of your seizures changed since you stopped taking a medicine? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think you may have had a seizure without loss of consciousness?
When to See a Doctor See significance of seizures without loss of consciousness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had a brief (2- to 30-second) period of unresponsiveness? Yes Have you had repeated twitching or jerking of one body part, such as your arm or leg? Yes Have you had episodes of more complex, purposeless repeated movement that occurred with a change in consciousness? Yes Have you had jerking or twitching movements of one side of your body? Yes Have you had twitching of your face? Yes Have you had an unusual feeling (aura) followed by a short time when you felt less awake or alert than usual? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have epilepsy and you are pregnant or thinking about becoming pregnant?
When to See a Doctor See significance of pregnancy and epilepsy if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you have epilepsy and you are pregnant? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Do you have epilepsy and you are thinking about becoming pregnant? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

If you witness a seizure, your account of the seizure will help a doctor diagnose and treat the person. Try to stay calm. Pay close attention to what happens during and after the seizure.

• During a seizure:
  • Protect the person from injury.
    • Keep him or her from falling if you can, or try to guide the person gently to the floor.
    • Try to move furniture or other objects that might injure the person during the seizure.
    • If the person is having a seizure and is on the ground when you arrive, put something soft under his or her head.
  • Do not force anything, including your fingers, into the person's mouth. Putting something in the person's mouth may cause injuries to him or her, such as chipped teeth or a fractured jaw. You could also get bitten.
  • Turn the person onto his or her side, with the mouth down, unless the person resists being moved.
  • Do not try to hold down or move the person.
  • Try to stay calm.
  • If the person vomits, turn the person onto his or her side.
  • Pay close attention to what the person is doing so that you can describe the seizure to rescue personnel or doctors.
    • What kind of body movement occurred?
    • How long did the seizure last?
    • How did the person act immediately after the seizure?
    • Are there any injuries from the seizure?
  • Time the length of the seizure, if possible.
• After a seizure:
  • Check the person for injuries.
  • If you could not turn the person onto his or her side during the seizure, do so when the seizure ends and the person is more relaxed.
  • If the person is having trouble breathing, use your finger to gently clear his or her mouth of any vomit or saliva.
  • Loosen tight clothing around the person's neck and waist.
  • Provide a safe area where the person can rest.
  • Do not give anything to eat or drink until the person is fully awake and alert.
  • Stay with the person until he or she is awake and familiar with the surroundings. Most people will be sleepy or confused after a seizure.

A person who has had a seizure should not drive, swim, climb ladders, or operate machinery until he or she has seen a doctor about the seizure and the doctor has said the person is allowed to drive or operate machinery.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms or Emergency sections to evaluate your symptoms if any of the following occur during home treatment:

• A second seizure occurs.
• Signs of a serious illness develop.
• The pattern of your seizures changes and you have a history of epilepsy.
• Symptoms become more severe or frequent.

Note: If you think you may have a seizure disorder or are being evaluated for one, do not drive, operate heavy machinery, swim, climb ladders, or participate in other potentially dangerous activities until you have been specifically cleared to do these things by your doctor.

Many causes of seizures, such as some forms of epilepsy, cannot be prevented. However, head injury is a common cause of seizures and epilepsy that you may be able to prevent. To prevent a head injury:

• Wear your seat belt when you are in a motor vehicle. Use child car seats.
• Do not use alcohol or other drugs before or during sports (such as soccer, football, horseback riding, or bicycling) or when operating an automobile or other equipment.
• Wear a helmet and other protective clothing whenever you are bicycling, motorcycling, skating, kayaking, horseback riding, skiing, snowboarding, or rock climbing.
• Wear a hard hat if you work in an industrial or construction area.
• Do not dive into shallow or unfamiliar water.
• Prevent falls at home by removing hazards that might cause a fall.
• Do not keep firearms in your home. If you must keep firearms, lock them up and store them unloaded and uncocked. Lock ammunition in a separate area.

If you are being treated for a seizure disorder:

• Be sure to follow your treatment plan. Taking too little or too much of your medicine, abruptly stopping your medicine, or changing your medicine schedule can cause seizures.
• Do not drive, operate heavy machinery, swim, climb ladders, or participate in other potentially dangerous activities until you have been specifically cleared to do these things by your doctor.
• Avoid activities that might trigger a seizure, such as playing video games that have flashing or flickering lights. In rare cases, the flashing lights and geometric patterns of video games can trigger seizures in children.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• How was your health and behavior before the seizure?
• Did you have any unusual symptoms before the seizure (aura)?
• What happened during the seizure? Ask the person who witnessed your seizure to either record this information for you or come to your doctor's appointment with you.
  • What kind of body movement occurred?
  • How long did the seizure last?
  • How did the person act immediately after the seizure?
  • Are there any injuries from the seizure?
• Have you ever had a seizure before? If so, what was the diagnosis and how were the seizures treated?
• If you have epilepsy:
  • What seizure medicines have been prescribed?
  • Has the dosage of your seizure medicine changed recently?
  • Have you taken your seizure medicine exactly as prescribed?
  • Have you taken other prescription or nonprescription medicines or consumed alcohol recently?
  • Have you used any alternative medicine products recently?
  • When was your last seizure?
  • On the average, how often do you have a seizure?
• Have you had other health problems in the past 3 months?
• Have you ever had a concussion (traumatic brain injury) in the past?
  • How long ago?
  • How severe was it?
  • Was there loss of consciousness?
  • What tests were used to evaluate your head injury?
• Have you had problems with headaches?
• Have you recently taken, stopped taking, or changed the dose of any medicines, including nonprescription medicines or illegal drugs?
• Have you suddenly reduced or stopped drinking alcohol?
• Have you recently traveled to a rural area or an undeveloped country?
• Do you have any health risks that may increase the seriousness of your symptoms?

If possible, ask the person who witnessed your seizure to come to your doctor's appointment with you. Be sure to ask your doctor what you can do to prevent another seizure and what to do if you have another seizure.

• Alcohol Abuse and Dependence
• Alcohol and Drug Problems
• Alzheimer's Disease
• Confusion, Memory Loss, and Altered Alertness
• Dealing With Emergencies
• Epilepsy
• Fever Seizures
• Fever, Age 3 and Younger
• Fever, Age 4 and Older
• Head Injury, Age 3 and Younger
• Head Injury, Age 4 and Older
• Human Immunodeficiency Virus (HIV) Infection
• Migraine Headaches
• Multiple Sclerosis (MS)
• Poisoning
• Preeclampsia and High Blood Pressure During Pregnancy
• Shock
• Stroke
• Tension Headaches
• Type 1 Diabetes
• Type 2 Diabetes

Author:	Jan Nissl, RN, BS	Last Updated: September 17, 2007
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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