What are seizures?

A seizure is essentially a "short circuit" in the brain—a sudden, uncontrolled burst of electrical activity between brain cells. This activity causes temporary changes in movement, behavior, feelings, or levels of consciousness.

While many people associate seizures with "falling and shaking," they can actually look very different depending on which part of the brain is affected.

Types of Seizures

Seizures are generally classified into two main categories based on where the electrical activity begins.

Tonic-Clonic (Grand Mal): The most recognizable type. Involves muscle stiffening (tonic phase) followed by rhythmic jerking (clonic phase).

Absence (Petit Mal): Common in children; looks like someone is daydreaming for 5–10 seconds.

Atonic (Drop Attacks): Sudden loss of muscle tone, causing the person to collapse.

Common Causes and Triggers

A single seizure doesn't always mean you have epilepsy (which is defined as having two or more unprovoked seizures). Seizures can be "provoked" by temporary factors:

Medical Issues: High fever (febrile seizures), low blood sugar, or electrolyte imbalances (like low sodium).

Brain Injury: Stroke, tumors, or traumatic head injuries.

Lifestyle Triggers: Lack of sleep, high stress, or alcohol withdrawal.

Photo-sensitivity: Flashing lights (though this only affects about 3% of people with epilepsy).

What to Do: First Aid

If you see someone having a seizure, the goal is to keep them safe, not to stop the seizure.

DO:

• Cushion their head with something soft.

• Turn them onto their side (this keeps the airway clear).

• Time the seizure.

• Stay with them until they are fully awake and alert.

DO NOT:

• Do not put anything in their mouth (they will not swallow their tongue).

• Do not restrain them or try to stop their movements.

When to call 911: If the seizure lasts longer than 5 minutes, if they are injured, if it's their first seizure, or if they don't wake up afterward.

Diagnosis and Treatment

If someone has recurring seizures, doctors use several tools to find the cause:

• EEG (Electroencephalogram): Records brain wave patterns to look for abnormal electrical "spikes."

• MRI/CT Scans: To check for structural issues like tumors or scarring.

• Treatment: Most people manage seizures effectively with Anti-Epileptic Drugs (AEDs). If medication doesn't work, other options include specialized diets (like the Ketogenic diet), Vagus Nerve Stimulation (VNS) devices, or surgery.

How Seizure Medications Work

Anti-Epileptic Drugs (AEDs) don't "cure" epilepsy; instead, they act like a stabilizer for the brain’s electrical system. They generally work in three main ways:

• Sodium Channel Blockers: This is the most common mechanism. To send a signal, brain cells open "gates" for sodium. Medications like Carbamazepine or Phenytoin keep these gates closed for slightly longer, preventing neurons from firing too rapidly or uncontrollably.

• GABA Enhancers: GABA is the brain’s natural "braking" chemical. Drugs like Benzodiazepines or Phenobarbital increase GABA activity, effectively "turning up the volume" on the brain's ability to calm itself down.

• Calcium Channel Blockers: Some seizures (like Absence seizures) involve specific electrical rhythms in the center of the brain. Medications like Ethosuximide block calcium channels to disrupt these specific rhythmic patterns.

• Glutamate Blockers: Glutamate is the brain’s "gas pedal" (excitatory). Some newer drugs work by weakening the glutamate signals so the brain doesn't become over-excited.

Seizure First Aid Kit Checklist

Whether for home or travel, a seizure-specific kit focuses on safety during the event and recovery afterward.

The Essentials:

• [ ] Rescue Medication: If prescribed (e.g., nasal sprays like Nayzilam or Valtoco), ensure they are not expired.

• [ ] Seizure Action Plan: A printed document detailing what your seizures look like, what meds you take, and when to call 911.

• [ ] Medical ID: A bracelet or a "Medical ID" card in a wallet.

• [ ] Soft Cushion/Flat Pillow: To place under the head during a seizure to prevent trauma.

• [ ] Stopwatch/Timer: To track the duration (crucial for medical decisions).

  
  

For Recovery (Post-Ictal Phase):

• [ ] Clean Clothes: It is common to lose bladder control during a seizure; a change of clothes provides dignity and comfort.

• [ ] Wet Wipes & Small Towel: For quick cleanup.

• [ ] Water & Electrolytes: Seizures are physically exhausting (like running a marathon in minutes); hydration is key.

• [ ] Simple Snacks: To help with low blood sugar or post-seizure fatigue.

  
  

For Travel:

• [ ] Original Prescription Bottles: Essential for TSA or if you need an emergency refill.

• [ ] Doctor’s Contact Info: A business card for your neurologist.

• [ ] Battery Backup: To ensure your phone (and any seizure-tracking apps) stays charged.

A Seizure Action Plan (SAP) is a clear, step-by-step guide for anyone who might be with you during a seizure (coworkers, teachers, or family). It removes the guesswork and helps them stay calm. 

Here is a template you can copy, fill in, and print:

​​

SEIZURE ACTION PLAN

Name: ____________________ DOB: __________

Emergency Contact: ____________________ Phone: _______________

Neurologist Name: ____________________ Phone: _______________

​

1. SEIZURE INFORMATION

• What my seizures look like: (e.g., staring, jerking, falling, confusion)

• Average duration: __________

• Common triggers: (e.g., lack of sleep, flashing lights, missed meds)

  
  

2. BASIC FIRST AID: "STAY, SAFE, SIDE"

• STAY with me and track the time.

• Keep me SAFE by moving sharp objects away.

• Turn me on my SIDE if I am not awake/alert.

• DO NOT put anything in my mouth or restrain me.

3. RESCUE MEDICATION (If applicable)

• Medication Name: ____________________

• Dose: __________

• When to give it: (e.g., "If seizure lasts longer than 3 minutes")

  
  

4. WHEN TO CALL 911

Call emergency services if:

• A seizure lasts longer than 5 minutes.

• I have a second seizure shortly after the first.

• I am injured, pregnant, or in water.

• I do not regain consciousness after the shaking stops.

5. AFTER THE SEIZURE (Recovery)

• I may be confused or tired. Please help me to: _______________________

• Other instructions: _____________________________________________

Next Steps for You

I recommend keeping a copy of this in your Seizure First Aid Kit and a digital copy on your phone.

After a seizure ends, the brain enters the "post-ictal phase." Think of this like a computer trying to reboot after a sudden crash—it takes time for all the systems to come back online, and the "startup" can be glitchy.

This phase can last anywhere from a few minutes to several hours, depending on the intensity of the seizure.

​How to Help During Recovery

The "reboot" process can be scary for the person waking up. Here is how you can provide the best support:

1. Reassure them: Use a calm, quiet voice. Say things like, "You're safe. You had a seizure, but it's over now. I'm right here."

2. Check for injuries: Once they are alert, gently ask if anything hurts. Check for head bumps or bleeding in the mouth.

3. Prevent "The Great Escape": Sometimes people in a post-ictal state try to walk away or wander while still confused. Gently guide them to stay seated or lying down until their head clears.

4. Do not offer food/water immediately: Wait until they are fully awake and able to swallow properly to prevent choking.

5. Document the details: While it’s fresh in your mind, write down:

6. What time it started and ended.

7. What the movements looked like (right side vs. left side).

8. How long it took for them to recognize you afterward.