Published November 28, 2023
The shock of seeing a loved one experience a seizure unexpectedly can be a frightening experience, but knowing what to do in that moment can help keep them safe.
A seizure is caused by an abnormal electrical impulse in the brain and can be triggered by many different things. For example, epilepsy is a disorder of the brain resulting in chronic seizures. They can also be caused by low blood sugar in those with diabetes, injury or trauma to the brain, a tumor or bleed, encephalitis, or meningitis, where there's inflammation of the brain or brain tissue.
A tonic-clonic seizure, known by many people as a grand mal seizure, can result in many of those classic physical manifestations people think of when they think of seizures. This can include flailing arms, legs kicking, shaking on the ground, eye rolling and drooling.
Andrew Ulrich, MD, vice chair of Clinical Operations at Yale New Haven Hospital, and professor of Emergency Medicine at Yale School of Medicine explains that seizures can also manifest in subtle ways.
“With absence seizures, unless you know that person has a seizure disorder, you may just think that they’re sitting there passively, not paying attention or that they’re staring off into space for a minute,” said Dr. Ulrich.
Absence seizures, previously known as petite mal seizures, may last only a few seconds and can come without warning. A febrile seizure can happen in young children with a fever and may also only last for a few seconds.
Different types of seizures should prompt a different response.
“If I see somebody on the ground shaking, legs kicking, they're unresponsive, the most important thing is to make sure that they don't harm themselves. Make sure that you protect them from hitting their heads or anything else against objects around them,” said Dr. Ulrich.
Other things you can do when witnessing a seizure:
Most seizures resolve quickly and don’t require a trip to the hospital, especially if the person who experienced the seizure has had one before and knows the cause. However, any time someone experiences a seizure unexpectedly, it’s important to follow up with a clinician.
“Seizures can occur at any stage in life and depending on what’s causing it, it may be a one-time event or if may happen again,” said Dr. Ulrich. “From our perspective in the emergency department, the primary objective is to stop the seizure activity because prolonged seizure activity is dangerous for the brain. Sometimes we're able to do that. Sometimes we're not and then the neurologists get involved to help us determine what's caused the seizure and whether this is something that is going to be problematic down the road.”
In some cases, medication or surgery may be necessary to treat underlying causes and help prevent future seizures.
