ARE ALL EPILEPTIC SEIZURES THE SAME?
There are many different kinds of epileptic seizure and the action required during and after a seizure will depend on the seizure type. Some people may experience more than one kind of seizure. Some people only experience seizures when they are asleep
HOW TO MANAGE A CONVULSIVE SEIZURE
(tonic clonic or clonic – previously known as Grand Mal) Most seizures happen without warning, last only a short time and stop without any special treatment. Injuries can occur, but most people do not come to any harm in a seizure, and do not usually need to go to hospital or see a doctor. When a person has a convulsive seizure it is possible that their regular breathing pattern will be interrupted and their colour, especially their lips, may be blue. Although this can be frightening to witness, it does not usually mean it is a medical emergency. (This is explained in more detail below).
WHAT TO DO DURING A CONVULSIVE SEIZURE
- Do prevent others from crowding round.
- Do put something soft under the person’s head to prevent injury.
- Do move the person ONLY if they are in a dangerous place, e.g. in the road, top of stairs.
- Do move furniture and objects away from the person, not the other way round.
- Do respect the person’s privacy.
- Do stay with the person, reassuring them they are safe
- Do try and time the seizure
- Do not attempt to restrain the convulsive movements. Allow the seizure to take its course.
- Do not put anything in the person’s mouth. There is no danger of swallowing the tongue and teeth can easily be broken.
WHEN THE SEIZURE HAS STOPPED
- Roll the person, if possible, on to their side into the recovery position.
- Wipe away any excess saliva and if breathing is still laboured check that nothing is blocking the throat such as dentures or food.
- Do all you can to minimise embarrassment. If the person has been incontinent, deal with this as privately as possible.
- Stay with the person giving reassurance until they have fully recovered.
IT IS A MEDICAL EMERGENCY AND MEDICAL ASSISTANCE SHOULD BE SOUGHT IF
- Someone has injured themselves badly in a seizure.
- They have trouble breathing after a seizure.
- One seizure immediately follows another or the seizure lasts more than five minutes and you do not know how long they usually last.
- The seizure continues for longer than usual for that person.
- It is someone’s first seizure or you don’t know whether the person has had one in the past
ACTION FOR OTHER SEIZURE TYPES
COMPLEX PARTIAL SEIZURES
The person becomes suddenly confused, wanders around aimlessly or acts as if they do not understand what they are doing (picks up objects, removes clothes, etc):
Do not restrain the person, but guide away from danger, such as wandering into the road; speak gently and calmly to the person to help reorientation to surroundings as quickly as possible.
SIMPLE PARTIAL SEIZURES
In these types of seizures there is no loss of consciousness and the person is aware of what is happening to them. However, the seizure effects can be disturbing for the person experiencing them and reassurance and comfort may be appropriate. If this type of seizure is a warning (sometimes called an aura) that a convulsive seizure will follow, the person may need assistance in making themselves as safe as possible before it occurs.
TONIC AND ATONIC SEIZURES
The person falls and then recovers with or without confusion: Reassure, check for injury and stay with them until fully recovered.
(previously known as petit mal) The person has a brief interruption of consciousness. This type of seizure is usually very brief, but the person may need to be guided away from danger.
HOW ELSE CAN I HELP?
Due to loss of awareness or consciousness, people with epilepsy often do not know what happens to them during a seizure Observers can provide vital information for the GP or neurologist, which can be very helpful in making a diagnosis of epilepsy and to determine what types of seizures are occurring. This enables the doctor to prescribe suitable anti-epileptic medication.
THE FOLLOWING INFORMATION MAY BE HELPFUL IN THIS WAY
- Keep a record of the dates and times that the seizures occur and how long for.
- Where was the person? What was he or she doing?
- Did the person mention any unusual sensations
- Did you notice any mood change
- What brought your attention to the seizures?
- Did the seizure occur without warning?
- Was there any loss of consciousness or an altered state of awareness?
- Did the person’s colour alter?
- Did any parts of the body stiffen, jerk or twitch? If so which parts?
- Did the person’s breathing alter?
- Did the person perform any actions, eg. mumble, wander about, fumble with clothing?
- Was the person incontinent?
- Did they bite their tongue?
- How were they after the seizure?
- Did they need to sleep? If so, for how long?
- How long before the person was able to resume their normal activities?