Understanding Epilepsy: From Causes and Types to Essential First Aid
Learn about epilepsy, its causes, different seizure types, first aid steps, and when to seek emergency help. Stay informed to support loved ones with confidence.
Written by Dr. Siri Nallapu
Reviewed by Dr. Dhankecha Mayank Dineshbhai MBBS
Last updated on 30th Sep, 2025
Introduction
Witnessing someone have a seizure can be a frightening experience. The sudden change in consciousness, the stiffening of the body, or the rhythmic jerking movements can leave you feeling helpless. But knowledge is power. Understanding what epilepsy is, what causes it, how to recognise its different forms, and, most importantly, how to administer proper first aid can make you a crucial source of support and safety. Epilepsy is not a single disease but a spectrum of neurological disorders characterised by a tendency to have recurrent, unprovoked seizures. These seizures are the result of sudden, excessive electrical discharges in the brain's nerve cells. This article will guide you through the fundamental causes, help you identify the common types of seizures, and provide a clear, actionable plan for first aid. Whether you have a loved one with epilepsy or simply want to be prepared, this knowledge can empower you to act calmly and effectively in a critical moment.
What is Epilepsy? A Brief Overview
Epilepsy is a chronic non-communicable disease of the brain that affects millions of people worldwide. It is defined by a long-term predisposition to generate epileptic seizures. It's crucial to understand that a single seizure does not constitute epilepsy; the diagnosis typically requires at least two unprovoked seizures occurring more than 24 hours apart. The condition can develop at any age, and its impact varies significantly from person to person. For some, seizures are well-controlled with medication, allowing them to live full lives. For others, seizures may be more frequent and disruptive. The core of the disorder lies in the complex electrical signalling system of the brain. When this system is disrupted by a sudden, synchronised burst of electrical energy, it can temporarily interfere with normal brain function, leading to the physical and sensory manifestations we recognise as a seizure.
What Leads to Epilepsy? Uncovering the Root Causes
In about half of all cases, the direct cause of epilepsy cannot be identified. This is known as idiopathic or cryptogenic epilepsy. However, in the other half, a specific cause can be pinpointed. Understanding these causes is key to diagnosis and treatment.
Genetic Influences and Inherited Factors
Some types of epilepsy are known to run in families, suggesting a strong genetic component. Researchers have linked specific genes to certain epilepsy syndromes. These genetic forms often, but not always, begin in childhood. The inherited trait is usually a lower seizure threshold, meaning the brain is more susceptible to the electrical malfunctions that cause seizures.
Structural Brain Changes and Injuries
Any damage or alteration to the brain's structure can lead to epilepsy. This is known as structural epilepsy. Common causes include:
• Head Trauma: Severe injuries from accidents can lead to epilepsy, sometimes years later.
• Brain Tumours: Both benign and malignant tumours can cause seizures.
• Stroke: A stroke, which interrupts blood flow to the brain, is a leading cause of epilepsy in older adults.
• Brain Infections: Meningitis, encephalitis, and neurocysticercosis can cause scarring that leads to seizures.
• Prenatal Injury: Brain damage before birth due to infection, poor nutrition, or oxygen deficiency can result in epilepsy.
Infectious Diseases and Metabolic Imbalances
Certain infections, particularly those that affect the brain directly, are a major cause of epilepsy globally. Additionally, systemic issues like severe electrolyte imbalances, low blood sugar (hypoglycaemia), or kidney or liver failure can trigger seizures. These are often considered "acute symptomatic seizures" rather than epilepsy if they only occur during the illness.Consult a Neurologist for the best advice
Common Seizure Triggers to Be Aware Of
For people with epilepsy, specific factors can increase the likelihood of a seizure. These are not causes but triggers. Recognising and avoiding them is a vital part of management. Common seizure triggers include:
• Lack of sleep or fatigue
• High stress or emotional excitement
• Flashing lights or patterns (photosensitivity)
• Alcohol or drug use
• Hormonal changes related to the menstrual cycle
• Skipping meals or specific food ingredients (rare)
If you or a loved one experiences recurrent seizures, it's essential to consult a specialist to identify potential causes. Consulting a neurologist online with Apollo24|7 can be a convenient first step to discuss symptoms and determine the need for further investigation.
Recognising the Different Types of Epileptic Seizures
Seizures are categorised based on where they start in the brain and how they affect consciousness. The main division is between focal onset and generalised onset seizures.
Focal Onset Seizures: When It Starts in One Area
These seizures begin in just one part of one hemisphere of the brain. The experience depends entirely on the function of that specific brain area.
Focal Aware Seizures (Simple Partial)
During these seizures, the person remains fully conscious and aware. Symptoms of an epileptic seizure of this type can include:
• Sudden jerking of a limb.
• A feeling of déjà vu or jamais vu.
• Unusual tastes or smells.
• A rising sensation in the stomach.
• Tingling or numbness.
Focal Impaired Awareness Seizures (Complex Partial)
These affect a larger part of the brain and cause a loss of awareness or consciousness. The person may appear confused, dazed, and perform repetitive, involuntary movements called automatisms (e.g., lip-smacking, chewing, fumbling, or walking in circles).
Generalised Onset Seizures: Widespread Brain Involvement
These seizures involve both sides of the brain from the very beginning, often affecting consciousness immediately.
Tonic-Clonic Seizures (Grand Mal)
These are the most recognised and dramatic type of seizure. They have two distinct phases:
1. Tonic Phase: The person loses consciousness, muscles stiffen, and they may fall to the ground. This phase typically lasts 10–20 seconds.
2. Clonic Phase: The muscles begin to rhythmically jerk and convulse. This phase usually lasts for 1–2 minutes.
Absence Seizures (Petit Mal)
Most common in children, these are brief lapses in consciousness that look like a blank stare. The person may stop talking mid-sentence or blink rapidly. They usually last only a few seconds and the person resumes normal activity immediately afterwards, often unaware the seizure occurred.
Other Generalised Seizure Types
These include myoclonic seizures (brief, shock-like jerks), atonic seizures (sudden loss of muscle tone causing "drop attacks"), and tonic seizures (stiffening without the clonic jerking).
Epilepsy First Aid: Your Step-by-Step Action Guide
Knowing how to help someone having a seizure is the most critical part of this guide. Your goals are simple: keep the person safe until the seizure stops naturally.
First Aid for Tonic-Clonic (Convulsive) Seizures
1. Stay Calm & Time the Seizure.
2. Ease the Person to the Floor and clear the area of hard or sharp objects.
3. Cushion Their Head with something soft, like a folded jacket.
4. Loosen Tight Clothing around the neck, such as a tie or collar.
5. Turn Them Onto Their Side (Recovery Position) as soon as the jerking stops, or if possible during the jerking, to help keep their airway clear.
6. Stay with Them until they are fully awake and alert. The post-seizure (postictal) period can involve confusion, fatigue, and disorientation.
First Aid for Non-Convulsive Seizures (Focal Impaired Awareness)
• Stay calm and speak gently.
• Guide the person away from danger. Do not restrain them, but gently steer them away from traffic, stairs, or other hazards.
• Do not try to shake or shout at them to "snap out of it." This will not work and may cause agitation.
• Stay with them until full awareness returns.
What NOT to Do During a Seizure
This is as important as knowing what to do.
• DO NOT restrain the person.
• DO NOT put anything in their mouth. This can chip teeth or cause choking.
• DO NOT try to give them water or pills until they are fully alert.
• DO NOT perform CPR. Breathing often stops briefly during a seizure but typically resumes normally afterwards.
When is a Seizure a Medical Emergency?
Most seizures are not medical emergencies. However, call for an ambulance immediately if:
• The seizure lasts longer than 5 minutes.
• A second seizure begins immediately after the first ends.
• The person has difficulty breathing afterwards.
• The seizure occurs in water.
• The person is pregnant, injured, or has diabetes.
• The person does not regain consciousness after the jerking stops.
• It is the person’s first known seizure.
If you are unsure about the severity of a condition, you can book a physical visit to a doctor with Apollo24|7 for a thorough evaluation and personalised advice.
Conclusion
Understanding epilepsy demystifies the condition and replaces fear with practical competence. By learning about the diverse causes, from genetic predispositions to brain injuries, and recognising the spectrum of seizure types—from brief absence spells to full tonic-clonic episodes—we can better support those living with this condition. The cornerstone of this support is knowing how to administer simple, effective first aid that prioritises safety and dignity. Remember, your calm presence and informed actions are the most powerful tools during a seizure. Share this knowledge with your family, friends, and colleagues. If this information raises questions about your own health or that of a loved one, take the next step and seek professional guidance. Consulting a neurologist online with Apollo24|7 can provide clarity and a path towards effective management, turning uncertainty into empowered action.Consult a Neurologist for the best advice
Consult a Neurologist for the best 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 Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(150+ Patients)
Dr S Selvin
Neurologist
10 Years • MBBS, MD, DM (Neurology), FINR fellowhsip in Interventional Neuro Radiology
Chennai
Apollo Speciality Hospitals Vanagaram, Chennai
Consult a Neurologist for the best 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 Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(150+ Patients)
Dr S Selvin
Neurologist
10 Years • MBBS, MD, DM (Neurology), FINR fellowhsip in Interventional Neuro Radiology
Chennai
Apollo Speciality Hospitals Vanagaram, Chennai
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Frequently Asked Questions
1. Can you swallow your tongue during a seizure?
No, this is a physical impossibility. The muscle that controls the tongue may cause it to fall back, potentially obstructing the airway, which is why turning the person on their side is recommended. Never try to grab the tongue.
2. What is the difference between epilepsy and a seizure?
A seizure is a single event of abnormal electrical activity in the brain. Epilepsy is the underlying neurological condition (or tendency) that causes a person to have recurrent, unprovoked seizures.
3. What should I do after a seizure stops?
Stay with the person. They will likely be confused and tired (the postictal state). Speak calmly, reassure them of what happened, and ensure they are in a safe place until they are fully oriented. Do not offer food or drink until they are fully alert.
4. Can epilepsy be cured?
While there is no universal 'cure,' many forms of epilepsy can be very effectively managed. For some, medication can completely control seizures. For others, especially where a structural cause is found, surgery may be an option. Treatment is highly individual.
5. Are all seizures dramatic with convulsions?
No. This is a common misconception. Many seizures are subtle, such as brief staring spells (absence seizures) or sensory changes (focal aware seizures). These non-convulsive seizures can often go unnoticed or be mistaken for daydreaming.