Warning Signs of a Seizure and How to Help

Being around a person having a seizure can be a scary experience. Learning the warning signs of a seizure and how to help can prepare you to act quickly in the moment.

Seizures are not uncommon and can be caused by immediate injury or trauma, illness, infection, or many chronic health conditions. According to the Centers for Disease Control and Prevention (CDC), 1 in 10 people has a seizure at some point in their lifetime. If you encounter someone who’s experiencing a seizure, don’t panic. There are things you can do to help.

Ali S. Raja, MD, a Mass General Brigham emergency medicine doctor, describes the signs of a seizure, how long seizures last, and shares the steps that you can take to keep everyone as safe as possible.

What are the warning signs of a seizure?

While some people may be aware that a seizure is coming on, others may be totally unaware of the onset, or have little to no warning. Some warning signs also can be subtle. Knowing the signs and symptoms of a seizure means you can help in an emergency.

During a seizure, uncontrolled electrical impulses in the brain send faulty signals that can cause signs and symptoms, like:

• Delays in responsiveness
• Temporary paralysis
• Unconsciousness
• Spasms throughout part or all of the body
• General confusion, anxiety, or emotional distress

If you observe these signs, follow these steps below.

What to do if someone has a seizure

Here’s what you can do to help prevent injury and keep them safe during and after a seizure:

Step 1: Provide seizure first aid and injury prevention.

Do:

• Carefully ease them onto the floor or ground.
• Lay them on their side.
• Remove any clothing or jewelry that may injure them or restrict their breathing.
• Clear the area of people and things.
• Find something soft to put under their head.

Do not:

• Hold the person down. You could injure the person or yourself.
• Put anything in their mouth. This could hurt their teeth, gums or jaw, or they could swallow the object.
• Attempt mouth-to-mouth CPR breaths. You could injure them.
• Give them water or food unless they are fully alert. They could choke.

There are some common epilepsy myths and following the tips above can help keep everyone safe. For example, some people think it’s possible for someone having a seizure to swallow their tongue, but it’s physically impossible to do that. Others may worry that a person’s tongue could block the airway while they’re having a seizure. This also isn’t possible.

Step 2: Actively monitor the person during the seizure and after it concludes.

Watch anyone who is having a seizure closely, during and after. Following a seizure, they may be disoriented, not feel well, or retain some level of confusion that could affect their ability to function normally.

Even after the seizure ends, continue to support the person and get them additional help if needed. Here are some things you can do to assist:

• Stay with them until the seizure is over.
• Safely help them sit up.
• Explain what has happened (if they’re unaware).
• Try to calm or soothe them if they’re distressed or confused.
• Look for a medical ID bracelet, card, or other information they may have to help to identify an existing health condition.
• Once they’re feeling back to normal, call a friend or family member of theirs, or a taxi or rideshare service, to pick them up and make sure they get home safely.

Step 3: Determine the length of the seizure and when to call 9-1-1.

How long do seizures last? When should you call 9-1-1?

Not all seizures are emergencies, and most seizures last only about 30 seconds to 2 minutes. However, some seizures require emergency care, especially if the person hasn’t had one before.

Always call 9-1-1 if the seizure lasts more than 5 minutes or the person:

• Is injured
• Is in water
• Is pregnant or has other known health conditions
• Has trouble breathing or waking up
• Has never had a seizure before
• Has another seizure soon after the first

What causes seizures?

While the cause of a seizure isn’t always known at the time it occurs, there are some common causes and triggers you can keep in mind:

Health conditions that may cause seizures

• Epilepsy
• Traumatic brain injury (TBI) or other head trauma
• Fever above 101 degrees Fahrenheit (febrile seizure)
• Stroke
• Brain infection (encephalitis, meningitis)
• Brain tumor
• Severe illnesses including flu and COVID-19
• Lack of sleep

Other seizure triggers

• Reactions to or withdrawal from certain medications or illegal drugs
• Reactions to or withdrawal from alcohol
• Rapidly flashing lights (photosensitive seizures)

Keep calm and you can help someone who is having a seizure.

Encountering someone who is having a seizure can be a scary and uncertain situation. But if you follow the right steps, you can make sure that everyone stays safe and that you keep the person having the seizure from injuring themselves. Let them know that it will be okay when the seizure has passed.