A seizure is a sudden burst of abnormal electrical activity in the brain. That surge scrambles the signals controlling movement, awareness, and sensation, which is why one seizure can look like violent shaking and another can look like someone briefly staring through you. Most seizures stop on their own within a couple of minutes. You cannot shorten one once it starts, but what you do in those minutes genuinely affects whether the person gets hurt.
What to do while it is happening
Your job is to protect the person and keep track of time. Stay with them and start timing the moment it begins, because that number decides everything that comes next.
- Ease them to the ground and put something soft under the head
- Move away furniture, glasses, and anything hard or sharp
- Turn them onto their side, which lets saliva drain and keeps the airway clear
- Loosen anything tight around the neck
- Stay until they are fully alert, and speak calmly
Two things you should never do. Do not hold them down or try to stop the movements, which causes injuries rather than preventing them. And never put anything in their mouth, including your fingers. People cannot swallow their tongue, and objects in the mouth break teeth and block breathing.
Call 911 if any of these apply
Most seizures in someone with diagnosed epilepsy end on their own and follow their usual pattern. Call 911 when the situation goes beyond that:
- The seizure lasts longer than five minutes
- A second seizure follows before the person recovers
- Breathing is difficult, or the person does not wake up afterward
- It is their first seizure ever
- It happened in water, or the person was injured
- The person is pregnant, has diabetes, or has a fever with the seizure
The five minute mark matters most. A seizure that will not stop on its own can begin depriving the brain of oxygen, and it needs medication to break the cycle.
Not every seizure means epilepsy
This surprises people. A first seizure often points to something treatable happening in the body rather than a lifelong condition, which is a large part of why evaluation matters.
Severely low blood sugar is a common culprit, particularly in people taking insulin, and it is one we can identify and correct quickly. Seizures can also follow dehydration and the electrolyte swings that come with it, high fevers in young children, head injuries, infections such as meningitis, alcohol withdrawal, and dangerously high blood pressure in later pregnancy. Our on-site lab and imaging let us sort through those possibilities in one visit instead of several.
Staring spells and seizures that do not look like seizures
Not every seizure involves convulsions, and the quiet ones get missed for months. A teenager who blanks out mid-sentence for a few seconds, does not respond, then carries on as though nothing happened may be having absence seizures. These often get read as daydreaming or trouble paying attention in class.
Others begin in one area of the brain and stay there. An arm jerks, the face twitches, a strange smell or taste arrives out of nowhere, or a wave of intense familiarity washes over the person. Awareness may stay intact or fade partway through, and confusion afterward is common. Any of these patterns deserves a medical evaluation even though nobody hit the floor.
What happens after the seizure
The recovery period throws people off almost as much as the seizure. Confusion, deep exhaustion, headache, and muscle soreness are all expected, and full clarity can take anywhere from minutes to hours.
Nausea and vomiting afterward are common too, and on their own they are not alarming. Roll the person onto their side so they do not choke. Some people lose bladder control or bite the tongue during a seizure, which is normal and worth mentioning to whoever examines them. Get help if the confusion keeps deepening rather than lifting, if a headache is severe, or if the person cannot be roused.
Emergency seizure care in Houston and Sugar Land
Anyone having a first seizure should be evaluated, and so should anyone whose seizures change in pattern, length, or frequency. Life Savers ER is a freestanding emergency room, not an urgent care, with board-certified physicians, on-site labs and imaging, and a no-wait policy, so a first seizure gets worked up immediately rather than after a long wait. Check in online, or come straight to our Willowbrook, Heights, Summerwood, or Sugar Land location. If you witnessed a seizure and are unsure what to do next, bring the person in and let us take it from there.=
