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Seizures

Topic Overview

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 have symptoms before the seizure (auras) or 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. For more information, see the topic Epilepsy.

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

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) 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 can be 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 help the person having 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.

Check your symptoms to decide if and when you should see a doctor.

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  Epilepsy: Taking Your Medicines Properly

Check Your Symptoms

Do you think that you have had a seizure?
Yes
Seizure
No
Seizure
How old are you?
6 years or younger
6 years or younger
7 to 11 years
7 to 11 years
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female
Did your child have a seizure while he or she had a fever?
Yes
Fever at time of seizure
No
Fever at time of seizure
Do you have symptoms of a serious illness?
Yes
Symptoms of serious illness
No
Symptoms of serious illness
Have you had any new neurological symptoms other than seizures?
Yes
Neurological symptoms
No
Neurological symptoms
Do you have a severe headache that started suddenly and is the worst headache of your life?
This probably would not be like any headache you have had before.
Yes
Sudden, severe headache
No
Sudden, severe headache
Did the seizure occur after you swallowed something poisonous, drank a lot of alcohol, or used illegal drugs?
Yes
Possible poisoning or overdose
No
Possible poisoning or overdose
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Are you more than 20 weeks pregnant?
Yes
More than 20 weeks pregnant
No
More than 20 weeks pregnant
Do you have diabetes?
Yes
Diabetes
No
Diabetes
Do you think the seizure might have been caused by a problem with your blood sugar?
Seizures can sometimes occur if blood sugar gets too high or too low.
Yes
Diabetes may be causing seizure
No
Diabetes may be causing seizure
Do you have epilepsy or a history of seizures?
Yes
Epilepsy or history of seizures
No
Epilepsy or history of seizures
Was this a typical seizure for you?
Yes
Typical seizure
No
Typical seizure
Do you feel like you are returning to normal the way you usually do after a seizure?
You probably know what is typical for you right after a seizure ends. Think about whether this time seems different.
Yes
Typical return to normal after seizure
No
Typical return to normal after seizure
Have you been having seizures more often than usual or having different seizures than what you are used to?
Yes
Increase in number or change in type of seizures
No
Increase in number or change in type of seizures
Have you returned to normal, other than maybe feeling tired or a little sore?
Yes
Returned to normal after seizure
No
Returned to normal after seizure
Did the seizure occur within the past 2 hours?
Yes
Seizure occurred within past 2 hours
No
Seizure occurred more than 2 hours ago
Have you returned to normal, other than maybe feeling tired or a little sore?
Yes
Returned to normal after seizure
No
Returned to normal after seizure
Did the seizure occur less than 24 hours ago?
Yes
Seizure occurred less than 24 hours ago
No
Seizure occurred less than 24 hours ago
Did the seizure occur after a head injury?
Yes
Seizure occurred after head injury
No
Seizure occurred after head injury
Are you having any strange symptoms that you think could be a seizure?
These could include things like jerking, twitching, or repeated movements that you can't explain, or short periods (2 to 30 seconds) when you are not aware and cannot respond or when you feel less alert or awake for no reason.
Yes
Possible seizure symptoms
No
Possible seizure symptoms
Did these symptoms occur less than 24 hours ago?
Yes
Possible seizure symptoms less than 24 hours ago
No
Possible seizure symptoms less than 24 hours ago
Do you have any other concerns about seizures?
Yes
Other seizure concerns
No
Other seizure concerns

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of serious illness in a baby may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn't respond at all to being held, touched, or talked to.
  • The baby is hard to wake up.

Neurological symptoms—which may be signs of a problem with the nervous system—can affect many body functions. Symptoms may include:

  • Numbness, weakness, or lack of movement in your face, arm, or leg, especially on only one side of your body.
  • Trouble seeing in one or both eyes.
  • Trouble speaking.
  • Confusion or trouble understanding simple statements.
  • Problems with balance or coordination (for example, falling down or dropping things).
  • Seizures.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it's hard for you to function).
  • Shaking chills.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Fever Seizures

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Home Treatment

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 that the person is allowed to drive or operate machinery.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

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

Prevention

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. But 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.

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.

Preparing For Your Appointment

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?
    • Did you lose 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.

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Revised May 8, 2012

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