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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 don't lose consciousness. Other people may become unconscious and have shaking of the entire body.
Shaking of the body doesn't always occur with seizures. Some people who have seizures have symptoms before the seizure (auras). Or they may briefly lose touch with their surroundings and seem to stare into space. The person is awake. But they don't respond normally. Afterward, the person doesn't remember the episode.
Some people will have only one seizure during their lifetime. A single seizure usually lasts less than 3 minutes and isn't followed by a second seizure. Any healthy person can have a single seizure under certain conditions. If you have a first-time seizure, you should be checked by your doctor. It's important to rule out a serious illness that may have caused the seizure.
Causes of seizures
Epilepsy is a nervous system problem that causes seizures. It can occur at any age.
A seizure can be a symptom of another health problem, such as:
- A fever.
- An extremely low blood sugar level in a person who has diabetes.
- Damage to the brain from a stroke, brain surgery, or a head injury.
- Problems that someone has had since birth (congenital problems).
- Withdrawal from alcohol, prescription medicine, or illegal drugs.
- An infection, such as meningitis or encephalitis.
- A brain tumor or structural defect in the brain, such as an aneurysm.
- Parasitic infections, such as tapeworm or toxoplasmosis.
- Eclampsia, which is pregnancy-related seizure activity that is related to high blood pressure.
- Psychogenic non-epileptic seizure (PNES), which is a condition that can cause seizure-like activity related to a mental health issue.
Treatment of a seizure depends on what caused it.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
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, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or 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.
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.
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).
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.
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.
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.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
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.
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.
Caring for someone who is having a seizure
If you witness a seizure, try to stay calm. Pay close attention to what happens during and after the seizure. How you describe the seizure afterward will help a doctor diagnose and treat the person. For example, how did the person's body move? How long did the seizure last? How did the person act before and right after the seizure? Did the person have any injuries from the seizure?
No matter what caused the seizure, there are things you can do to help a person who is having a seizure.
- Protect the person from injury.
Keep them from falling if you can. Or try to guide the person gently to the floor.
- Move furniture or other objects that might injure the person during the seizure.
- Position the person on their side so that fluid can leak out of the mouth.
But be careful not to apply too much pressure to the body.
- Don't force anything, including your fingers, into the person's mouth.
Putting something in the person's mouth may cause injuries, such as chipped teeth or a fractured jaw. You could also get bitten.
- Don't try to hold down or move the person.
This can cause injury, such as a dislocated shoulder.
Caring for someone after a seizure
No matter what caused the seizure, you can help someone after they've had a seizure.
- Check the person for injuries.
- Turn the person onto their side.
If you couldn't turn the person during the seizure, do it when the seizure ends and the person is more relaxed.
- Make sure that the person can breathe.
If the person is having trouble breathing, call 911.
- Loosen tight clothing around the person's neck and waist.
- Provide a safe area where the person can rest.
- Don't give anything to eat or drink until the person is fully awake and alert.
- Stay with the person until they are 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 they've seen a doctor about the seizure and the doctor has said it's okay to drive or operate machinery.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- There's a history of epilepsy, and the pattern of seizures changes.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: December 13, 2021
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine