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A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain.
The term "seizure" is often used interchangeably with "convulsion." Convulsions are when a person's body shakes rapidly and uncontrollably. During convulsions, the person's muscles contract and relax repeatedly. There are many different types of seizures. Some have mild symptoms and no body shaking.
Secondary seizures; Reactive seizures; Seizure - secondary; Seizure - reactive; Convulsions
It may be hard to tell if someone is having a seizure. Some seizures only cause a person to have staring spells. These may go unnoticed.
Specific symptoms depend on what part of the brain is involved. They occur suddenly and may include:
Symptoms may stop after a few seconds minutes, or continue for 15 minutes. They rarely continue longer.
The person may have warning symptoms before the attack, such as:
Seizures of all types are caused by disorganized and sudden electrical activity in the brain.
Causes of seizures can include:
Sometimes no cause can be identified. This is called idiopathic seizures. They usually are seen in children and young adults but can occur at any age. There may be a family history of epilepsy or seizures.
If seizures repeatedly continue after the underlying problem is treated, the condition is called epilepsy.
Most seizures stop by themselves. However, the patient can be hurt or injured during a seizure.
When a seizure occurs, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects.
Cushion the person's head.
Loosen tight clothing, especially around the person's neck.
Turn the person on his or her side. If vomiting occurs, this helps make sure that the vomit is not inhaled into the lungs.
Look for a medical I.D. bracelet with seizure instructions.
Stay with the person until he or she recovers, or until you have professional medical help.
If a baby or child has a seizure during a high fever, cool the child slowly with tepid water. Do not place the child in a cold bath. You can give the child acetaminophen (Tylenol) once he or she is awake, especially if the child has had fever convulsions before.
For information on how to help someone who is having a seizure, see: Seizure first aid
Call 911 or your local emergency number if:
Report all seizures to the person's health care provider. The doctor may need to adjust or change the person's medications.
A person who has had a new or severe seizure is usually seen in a hospital emergency room. The health care provider will try to diagnose the type of seizure based on the symptoms.
Tests will be done to rule out other medical conditions that cause seizures or similar symptoms. This may include fainting, transient ischemic attack (TIA) or stroke, panic attacks, migraine headaches, sleep disturbances, and others.
Tests may include:
Further testing is needed if you have:
A single seizure due to an obvious trigger (such as use of a certain drug) is treated by eliminating or avoiding that trigger.
There is no specific way to prevent all seizures. However, the following tips may help control some of them:
You might help lower your risk of seizures if you:
You should not drive if you have uncontrolled seizures. Every U.S. state has a different law detailing which people with a history of seizures are allowed to drive. If you have uncontrolled seizures, you should avoid activities where loss of awareness would cause great danger, such as climbing to high places, biking, and swimming alone.
Duvivier EH, Pollack CV Jr. Seizures. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 100.
Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69(21):1991-2007.
Rubin DH, Kornblau DH, Conway EE Jr, Caplen SM. Neurologic Disorders. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 173.
Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009 May;116(6):758-67.