Guide to What Do When You Get Epilepsy Attack
Know about epilepsy attacks, what it is, types, what to do and what not to do. Learn about the myths, recovery phase and first aid for seizures.
Written by Dr. Mohammed Kamran
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 9th Sep, 2025
Introduction
Witnessing someone have an epileptic seizure or experiencing one yourself can be a frightening and overwhelming event. Epilepsy is a neurological condition characterised by recurrent, unprovoked seizures, affecting millions worldwide. This immediate response is not about stopping the seizure, which will run its course, but about protecting the person until it ends naturally. This guide provides a clear, actionable plan for seizure first aid, demystifying the process and empowering you to act with confidence and compassion.
Understanding Epilepsy and Seizure Types
Epilepsy is not a single disease but a spectrum disorder with a wide variety of seizure types and symptoms. Fundamentally, a seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in behaviour, movements, feelings, and levels of consciousness. Understanding the type of seizure you're witnessing can inform your response.
Consult a Neurologist for Personalised Advice
Focal Onset Seizures
These start in one specific area of the brain. Symptoms can vary widely:
- Without impaired awareness: The person may experience sudden emotions, jerking of a body part, or sensory changes, but remains aware.
- With impaired awareness, the person may appear confused, dazed, and fail to respond normally. They may exhibit repetitive movements, such as hand rubbing or chewing.
Generalised Onset Seizures
These involve widespread electrical discharges across both sides of the brain from the start.
- Tonic-Clonic (Grand Mal): The most recognised type. Involves stiffening (tonic phase) and rhythmic jerking (clonic
phase). Loss of consciousness is typical. - Absence (Petit Mal): Brief lapses of consciousness where the person may stare blankly for a few seconds. Common in children.
- Atonic (Drop Attacks): A sudden loss of muscle tone causes the person to collapse or drop their head.
- Myoclonic: Sudden, brief jerks or twitches of muscles or muscle groups.
Step-by-Step First Aid for a Tonic-Clonic (Convulsive) Seizure
This is the most common scenario requiring first aid. Follow these steps meticulously.
Your Immediate Actions: The First 3 Steps
1. Stay Calm and Time the Seizure: Check your watch or phone the second you notice it starts. Timing is critical for
knowing if it becomes a medical emergency.
2. Ease the Person to the Floor & Clear the Area: Gently guide them to a safe spot, preferably the floor. Quickly move
away from hard, sharp, or hot objects.
3. Protect Their Head: Place something soft and flat under their head, like a folded jacket, pillow, or towel, to prevent
head injury from hitting the floor.
What to Do During the Seizure Activity
Follow these:
- Turn Them on Their Side: If possible, especially once the jerking subsides, gently roll them onto their side. This helps
saliva or fluids drain from the mouth, preventing choking. - Loosen Restrictive Clothing, especially around the neck (ties, shirt collars) to aid breathing.
- Stay with Them: Speak to them in a calm, reassuring tone. They cannot hear or understand you, but a calm presence is important for bystanders and for when they wake up.
Critical Things to Avoid
It includes:
- Do not restrain: Holding the person down does not stop the seizure and can cause injuries like broken bones.
- Do not put anything in their mouth: The old myth of preventing someone from swallowing their tongue is false and
extremely dangerous. You could chip their teeth, injure their jaw, or get your fingers bitten. - Do not offer food or water: Until the person is fully alert, they cannot swallow safely and could choke.
- Do not perform CPR: Unless the seizure has stopped and the person is not breathing (check for chest movement), CPR
is not needed. Breathing often is shallow or may pause during a seizure.
First Aid for Non-Convulsive (Focal Impaired Awareness) Seizures
These "staring" or "confused" seizures require a different approach.
- Stay with Them and Guide Away from Danger: Gently guide them away from potential hazards like stairs, traffic, or
hot surfaces. - Do Not Grab Them: This can be startling or provoke agitation. Use calm, clear instructions.
- Block Access to Hazards: Instead of physically moving them, you might create a barrier.
- Speak Calmly and Reassuringly: They are confused and may be frightened. Identify yourself and let them know they
are safe. - Stay Until Full Awareness Returns: This can take several minutes after the seizure itself ends.
The Recovery Phase: After the Seizure Ends (Postictal Phase)
- The period after a seizure can be just as disorienting. The brain is recovering, and the person may be confused, fatigued,
scared, or embarrassed. - Continue to Stay with Them: They need support as they reorient themselves.
- Check for Medical ID: Look for a bracelet or necklace that provides emergency information.
- Explain Gently What Happened: Tell them they had a seizure and are safe.
- Offer to Call Someone: They should not drive, operate machinery, or be left alone until fully recovered. Offer to call a
family member, friend, or taxi.
It is crucial to recognise when a seizure is a medical emergency.
- The seizure lasts longer than 5 minutes.
- A second seizure begins immediately after the first one ends.
- The person does not regain consciousness or has difficulty breathing after the seizure stops.
- The seizure occurs in water.
- The person is injured during the seizure (e.g., from a fall).
- The person is pregnant, has diabetes, or has a known heart condition.
- It is the person’s first known seizure.
If your condition does not improve after trying these methods, or if you experience a first-time seizure, book a physical
visit to a doctor with Apollo24|7 for a comprehensive neurological evaluation.
Common Myths and Misconceptions About Seizure First Aid
Dispelling myths is a key part of providing safe care.
- Myth: You need to put a spoon in their mouth. FALSE. This is dangerous and can cause serious injury.
- Myth: You should try to hold them down. FALSE. This restricts natural movement and can cause harm.
- Myth: All seizures involve convulsions. FALSE. Many seizures present as staring spells, confusion, or sensory changes.
- Myth: You can "catch" epilepsy. FALSE. Epilepsy is not contagious.
Creating a Seizure Action Plan
For individuals with epilepsy, having a plan is empowering.
- Discuss with Your Doctor: Work with your neurologist to create a personalised plan.
- Share with Family, Friends, and Coworkers: Ensure your close circle knows what to do.
- Wear a Medical ID Bracelet: This provides critical information to first responders if you cannot.
- Consider a Seizure Alert Device: For some, technology can help notify caregivers.
Managing epilepsy effectively often requires regular monitoring. Apollo24|7 offers convenient home collection for tests
like therapeutic drug monitoring to check anti-epileptic medication levels in the blood, ensuring your treatment is on track.
Consult a Neurologist for Personalised Advice
Conclusion
Witnessing an epilepsy attack can be unsettling, but your knowledge and calm response are powerful tools. By remembering the core principles Stay Calm, Time It, Protect from Injury, Nothing in the Mouth, and Turn on Side, you can provide crucial first aid that keeps a person safe during one of their most vulnerable moments. If you or someone you know is affected by seizures, the most important step is to seek professional guidance for proper diagnosis and a long-term management plan.
Consult a Neurologist for Personalised Advice
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr Debnath Dwaipayan
Neurosurgeon
9 Years • MBBS, MS(Gen. Surgery), DrNB (Neurosurgery)
Delhi
Apollo Hospitals Indraprastha, Delhi
Consult a Neurologist for Personalised Advice
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr Debnath Dwaipayan
Neurosurgeon
9 Years • MBBS, MS(Gen. Surgery), DrNB (Neurosurgery)
Delhi
Apollo Hospitals Indraprastha, Delhi
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Frequently Asked Questions
1. What is the difference between an epilepsy attack and a fainting spell?
While both involve loss of consciousness, a seizure (epilepsy attack) often features rhythmic jerking, muscle stiffening, confusion afterward, and possible loss of bladder control. Fainting is typically preceded by dizziness, is brief, and consciousness returns quickly with minimal confusion.
2. Can you stop a seizure once it has started?
No, you cannot stop a seizure once the electrical storm in the brain has begun. It must run its course. First aid is focused on safety, not cessation. Rescue medications prescribed by a doctor can sometimes be administered to stop prolonged seizures, but this is a medical intervention.
3. Should I call an ambulance after every seizure?
Not necessarily. For a person with a known epilepsy diagnosis who has a brief seizure and returns to their normal state afterward, an ambulance may not be needed. However, you must always call 911 if the seizure lasts more than 5 minutes, if they are injured, or if it's their first seizure.
4. How long does it take to recover fully from a tonic-clonic seizure?
The recovery period (postictal phase) varies. It can last from a few minutes to several hours. The person may feel extreme fatigue, headache, muscle soreness, and confusion during this time and should rest.
5. What are the common triggers for an epileptic seizure?
Common triggers include missed medications, sleep deprivation, high stress, flashing lights (in photosensitive epilepsy), alcohol or drug use, hormonal changes, and illness with fever.