First Aid for Seizures: Signs, Causes, What Can Be Done

Passerby Helping Senior Woman with Seizure

A seizure can affect any person of any age. In fact, it is one of the most common diseases that inflict the nervous system.

It has been cited that around 70% of people who have been diagnosed with seizures could have gone on living without future seizure episodes if only they had been diagnosed properly and given appropriate treatment.

People who have recurrent seizures, or epilepsy, have up to 3 times higher risk of premature death compared to the majority of the population.

Seizures are a cause for medical concern. In incidents of seizures, calling a private ambulance service is beneficial in receiving urgent medical attention for the patient.

But what happens during a seizure? What are the underlying repercussions of this condition? Read on to find out everything about seizures: what causes it, what you can do as first-aid treatment to someone who suddenly suffers from this condition, and when a seizure case must be brought to the hospital.

You can also find out more about proper life support through our basic cardiac life support courses.

What are Seizures?

A seizure is a sudden change or disturbance in normal brain activity. This occurs when electrical activities between the neurons, or brain cells, become uncoordinated resulting in a burst. This burst causes short-term irregularity in movements, behavior, or state of consciousness.

A person having seizures can be seen as twitching involuntary, looking stiff, with limbs shaking. In some cases, losing consciousness can also be observed from a seizure episode.

Seizure circumstances vary per person. Some seizures occur as a single incident brought about by an isolated cause. However, persons who experience recurrent seizures may have epilepsy.

Seizures are considered a serious medical concern. When not given proper attention and treatment, it can cause brain damages and other life-threatening injuries, and sometimes, even fatality.

Different Types of Seizures

In 2017, the International League Against Epilepsy (ILAE) in Texas updated the seizure classification to provide a better and clear means to categorise seizure types. The new classification names two major types of seizures: focal onset seizures, and generalised onset seizures.

Focal Onset Seizures

Focal onset seizures, previously known as partial-onset seizures, are seizures that take place in one area of the brain.

While focal onset seizures only start on one part of the brain, the seizures can spread and affect other parts of the brain. Depending on how much of the brain is affected, the symptoms can be mild or severe.

Simple focal seizures

If a person is aware that they are having seizures, this is referred to as focal aware seizure or simple partial seizure/simple focal seizure.

With this kind of seizure, only a small part of the brain is affected. This results in an awareness of the situation, however, with unusual changes in sensations and movements of the person, like an odd taste or smell and twitching.

Complex focal seizures

If a person is unaware that they are having seizures, this is referred to as focal impaired awareness seizure or complex partial seizure/complex focal seizure.

This type of seizure is characterised by a slightly altered awareness, leaving the person in a state of confusion. This makes the person incapable of understanding directions nor responding to questions at least for the few minutes after the seizure takes place.

Secondary generalised seizures

Secondary generalised seizures are seizures that start on one part of the brain, eventually spreading to both sides.

That is, a person first suffers from a focal onset seizure and then a generalised onset seizure.

Generalised Onset Seizures

This type of seizure simultaneously affects both sides of the brain.

Generalised onset seizures are typically caused by an imbalance in the circuits of electrical activity in the brain. However, other factors can contribute to this seizure.

Genetic Considerations

Genetics can play into the development of generalised seizures, although the risk associated is very little as only a few people have been found to suffer generalised seizures share the same condition with a family member.

Apart from genetic attributes, lack of sleep, as well as excessive alcohol intake, can increase the risk of generalised onset seizures.

Types of Generalized-Onset Seizures

Absence Seizures (“Petit Mal Seizures”)

Also known as petit mal seizures, absence seizures are brief and random lapses from the person’s conscious state. These seizures are characterised by blank stares into space like daydreaming or a repeated blinking.

Childhood absence epilepsy

This type of seizure manifests as long staring episodes that occur in children between the ages of 4 to 6. The good news is that children usually outgrow this. Learn how to perform first aid for Child with our Child First Aid Course.

Juvenile absence epilepsy

This type of seizure starts a bit later on but usually carries on into adulthood. People who have this type of seizure are more likely to develop tonic-clonic seizures.

Myoclonic seizures

This type of seizure is characterised by sudden movements or jerking of the limbs, which may include arms, head, and neck. These seizures typically occur in the morning.

Tonic and Atonic Seizures (“Drop Attacks”)

“Tonic” refers to the stiffening of the muscle, so tonic seizures are characterised by the sudden stiffness of the arms and body, which can lead to dangerous falls and injuries.

“Atonic” refers to the jerking movement of the arms and legs. Atonic seizures are characterised by the instant loss of body tone that leads to a collapse, which can indicate injuries.

These seizures often occur in a sequence, called a tonic-atonic seizure.

Managed treatment of these seizures involves nerve stimulation and diet therapies, apart from special medications.

Tonic, Clonic, and Tonic-Clonic (formerly called Grand Mal) Seizures

These seizures often arise from a progressing focal or generalised seizure. When a focal onset seizure spreads to both sides of the brain, this can result in a tonic-clonic seizure. Furthermore, a cluster of myoclonic seizures can also turn into a tonic-clonic seizure. Other circumstances can also bring about this seizure type.

Symptoms of Seizures

There are scenarios when a person experiences both focal and generalised seizures one after the other or even simultaneously. A seizure episode can last anywhere from a few seconds to 15 minutes. During this period, you will be able to recognise various symptoms.

In some cases, there are noticeable symptoms before an actual seizure occurs. These include:

  • A random feeling of fear or anxiousness
  • A sensation of being sick to the stomach
  • Dizziness
  • A change in vision
  • A jerking movement of the arms and legs
  • An out of body sensation
  • A headache

Similarly, these are the symptoms that a person is indeed having a seizure:

  • Unconsciousness, which is then followed by a confused state
  • Uncontrollable muscle spasms and twitching
  • Drooling or foaming of the mouth
  • Having a strange taste in the mouth
  • Falling
  • Clenching the teeth
  • Biting the tongue
  • Sudden, rapid eye movements
  • Unusual noises, like grunting
  • Losing bladder and bowel function controls
  • Sudden mood changes

What to do when someone has a Seizure?

If you witness someone who is having a seizure, especially if it is a tonic-clonic seizure, here is what you need to do:

  • Remain calm, and stay with the person.
  • Keep track of the time when you first noticed the seizure symptoms.
  • Call emergency help as soon as possible, especially if the seizure persists for more than 3 minutes or the person does not regain consciousness after the seizure. Similarly, urgent medical help is needed if the person is having repeated seizures, is pregnant, or is the first time to have a seizure.
  • If the person having a seizure is standing, hold them and guide them to a safe spot on the floor. This prevents them from sustaining injuries from a fall.
  • Make sure to clear the area around the person who is having a seizure. Remove items that could cause them injuries.
  • If the person having a seizure is on the floor, try to roll them on their side. This is so that the saliva or vomit does not block their windpipe and drown or choke them.
    Provide a soft cushion for their head.

An important thing to remember: when a person is having a seizure, do not put anything into their mouth. Furthermore, do not hold them down or try to restrain them while they are having a seizure.

If a person starts having a seizure while they are in a wheelchair, car seat, or stroller, here is what you can do:

  • Do not remove the seatbelt unless it is causing injury
  • Use the wheelchair brakes.
  • If the wheelchair has tilt options, tile the seat and lock it in position.
  • Provide support to the person’s head until the seizure is over.
  • Lean the person slightly to one side so that any fluid in the person’s mouth is expelled and does not go down the windpipe.

Once the seizure is over but the person is having breathing difficulties, take them out of the wheelchair, and put them in a comfortable space and position to recover.

After-seizure care

When the seizure is over, you need to do the following:

  • Inspect the person for possible injuries.
  • If the person wasn’t on their side while having the seizure, do it when the seizure is over.
  • Using your finger, clear any saliva or vomit in their mouth that could be the cause of their breathing difficulties.
  • Loosen tight clothing around the neck and the wrists.
  • Remain with them until they gain full awareness of the situation.
  • Try not to offer them anything to eat or drink until they are fully conscious and aware.
  • Start asking them simple questions like who they are, where they are, and what day it is. Be patient with them as it may take a few minutes before they become capable of answering your questions.

If they are still having breathing difficulties, call an ambulance and keep the person in observation. Be prepared to perform CPR in the event their breathing comes to a halt.

If a seizure occurs in water

There are instances where a seizure occurs when the person is in a body of water like a pool, a surf, or a sauna. This is especially concerning and potentially life-threatening as aside from suffering from seizures, they might also drown right there at the moment. Here is what you can do to prevent the situation from worsening:

  • Provide support to the person’s head so that their face is out of the water.
  • If the person is in a pool, try to remove them from the water once the jerking movement stops. If, on a rare occasion that the jerking movements do not stop, seek help from others in getting the person out of the water.
  • If a person is in the surf, get them out of the water immediately.
  • You can use flotation devices and other aid in getting someone out of the water.
  • Seek help as much as possible.

Once out of the water

Once you have successfully removed the person having the seizure from the water, this is what you have to do:

  • Call for emergency help immediately.
  • Place the person on their side.
  • Check to see if they are breathing properly.
  • If the person is not breathing or not breathing normally, make the person lie on their back. Be ready to perform CPR.

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