Epilepsy and seizures: what families should know

A seizure is a short episode caused by a sudden burst of abnormal electrical activity in the brain. It can cause shaking, stiffening, staring, unusual sensations or loss of awareness. Epilepsy is a condition in which a person tends to have repeated seizures that are not caused by another immediate problem such as a high fever, low blood sugar or alcohol withdrawal.

Types of seizure

• Generalised seizures involve both sides of the brain. The best-known type causes stiffening and jerking of the whole body with loss of consciousness.
• Focal seizures start in one area of the brain. The person may stay aware and notice a strange feeling, or may stare and not respond, make repeated movements such as lip-smacking, and have no memory of it afterwards.

First aid during a seizure

• Stay calm and note the time the seizure started.
• Move hard or sharp objects away and cushion the head.
• Do not hold the person down and do not put anything in their mouth.
• When the shaking stops, turn them onto their side (the recovery position) and check their breathing.
• Stay with them until they are fully awake and know where they are.

Call 108 if:

• it is the person’s first seizure
• the seizure lasts more than 5 minutes, or one seizure follows another without the person waking in between
• the person is injured, has difficulty breathing, or the seizure happened in water
• the person is pregnant or has diabetes

How seizures are investigated

The most important information is an accurate description of the episode, ideally from someone who saw it. A short phone video, taken safely, can be very helpful. Tests may include an EEG (a recording of the brain’s electrical activity), an MRI scan of the brain and blood tests. A normal EEG does not rule out epilepsy, so the diagnosis is made by putting all the information together.

Treatment and daily life

Most people with epilepsy are treated with anti-seizure medicines; the World Health Organization estimates that up to 70% of people with epilepsy could live seizure-free with appropriate treatment. Medicines work best when taken regularly, without missed doses, and should not be stopped suddenly without medical advice. Good sleep and avoiding known triggers also help. Ask your neurologist about driving, swimming, work at heights and pregnancy planning, as advice depends on your seizures and treatment.