Seizures (also called convulsions or fits) occur when there is a sudden burst of abnormal electrical activity in the brain. They can be frightening, but most seizures last only a few seconds to a few minutes. Appropriate first aid is crucial to protect the person from injury and to ensure timely medical help if needed.
Immediate First Aid for Seizures
1. Stay Calm and Ensure Safety
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Stay with the person. Most seizures end on their own.
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Move dangerous objects away. Clear sharp, hard, or hot objects that could cause injury.
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Ease them to the ground. If standing, gently help them lie down to prevent falls.
2. Protect the Head and Body
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Place something soft under the head (jacket, pillow, folded clothing).
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Loosen tight clothing around the neck (e.g., ties, collars).
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Turn them onto their side (recovery position) if possible, to keep the airway clear and allow saliva/vomiting to drain.
3. Do NOT Do the Following
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Do not restrain the person’s movements during the seizure.
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Do not put anything in their mouth. This could block the airway or break teeth (contrary to old myths).
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Do not try to give food, drink, or medication until they are fully alert again.
4. Monitor Breathing and Duration
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Most people breathe normally again once the seizure ends.
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If breathing is noisy, gently roll them onto their side.
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Time the seizure. If it lasts more than 5 minutes, call emergency services.
5. After the Seizure (Postictal Phase)
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The person may be confused, tired, or fall asleep afterward.
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Stay with them until fully alert and oriented.
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Offer reassurance in a calm voice.
When to Call Emergency Services Immediately (Ambulance/911/Local number)
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Seizure lasting more than 5 minutes.
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Repeated seizures without recovery in between.
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Breathing difficulties or if the person turns blue.
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First-time seizure.
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Seizure occurring in water.
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Person is pregnant, has diabetes, heart disease, or serious injury during the seizure.
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Failure to regain full consciousness after a reasonable time.
Medical Treatment for Seizures (Long-term Management)
For individuals diagnosed with epilepsy or recurrent seizures, treatment involves anticonvulsant (antiepileptic) medications prescribed by doctors.
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Sodium Valproate: 600 mg/day orally in divided doses, gradually increased (usual range 1–2 g/day).
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Carbamazepine: Start 200 mg twice daily, increase as needed (usual 800–1200 mg/day).
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Lamotrigine: Start 25 mg daily, titrate slowly to 100–200 mg/day.
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Levetiracetam: Start 500 mg twice daily, may increase to 1500 mg twice daily.
Emergency treatment for prolonged seizures (status epilepticus):
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Diazepam rectal gel: 10–20 mg rectally, may repeat once after 4–12 hours.
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Midazolam buccal/nasal: 10 mg, used especially in children.
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IV Lorazepam: 4 mg IV slowly (hospital setting).
Precautions for People with Seizures
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Take medication regularly as prescribed.
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Avoid sleep deprivation, alcohol excess, and flashing lights if sensitive.
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Inform family, friends, teachers, or colleagues about seizure first aid.
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Wear a medical alert bracelet if diagnosed with epilepsy.
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