Seizures.

01 · Overview

The short version

02 · Care guidance

When to get help

If seizures are known and stable, schedule follow-up to review triggers, treatment response, safety planning, and whether any testing or medicine adjustment is needed.

03 · Seizures

What counts as a seizure

A seizure is a burst of abnormal brain activity that can change movement, awareness, speech, or behavior.

A seizure is a symptom of a brain problem. It happens when brain cells send sudden, abnormal electrical signals. That can cause shaking, but it can also cause staring, stiffening, a strange feeling, odd movements, confusion, or a brief pause in activity.

People may be fully awake, partly aware, or unaware during the event. Some seizures start in one part of the brain and are called focal seizures. Others involve both sides of the brain and are called generalized seizures. The outward signs can look very different from one person to the next.

That wide range is why a seizure can be missed or mistaken for fainting, panic, daydreaming, or a sleep-related event. The event itself may not leave lasting harm, but the cause still matters.

• Shaking is common, but not required.
• Awareness can be preserved or lost.
• The same person can have different seizure patterns.

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04 · Seizures

Why it happened, and what can look similar

Some seizures come from epilepsy, while others happen because something temporarily disrupted the brain.

Repeated unprovoked seizures are called epilepsy. Epilepsy can have many causes, including brain injury, illness, abnormal brain development, or no clear known cause. A person can also have a one-time seizure from something that briefly affects the brain, such as a medicine effect, high fever, head injury, or another disease process.

Clinicians also think about look-alike events. Fainting, panic, dissociation, cataplexy, and some sleep or movement disorders can resemble a seizure, especially if no one saw the start of the episode. Witness details help, but they do not replace medical evaluation.

Recent medicine changes, alcohol or drug use, missed doses, sleep loss, infection, fever, and pregnancy are important clues because they can point toward a trigger or a more serious cause.

• A clear trigger does not rule out the need for evaluation.
• Seizure-like spells are not all epilepsy.
• Bring a complete medicine and substance list to the visit.

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05 · Seizures

What to do during the episode

Protect the person from injury, keep the airway clear, and do not put anything in the mouth.

If someone is having a seizure, move hard or sharp objects out of the way if you can do so safely. Help them lie on their side if possible, loosen tight clothing around the neck, and watch the time. Stay with them until they are fully awake and breathing normally.

Do not hold the person down, do not try to stop the movements, and do not put food, drink, medicine, or fingers into the mouth. Those actions can cause choking or injury. Afterward, the person may be confused, tired, sore, or embarrassed, so a calm, simple explanation can help them reorient.

If the event happens near water, stairs, traffic, or machinery, safety steps matter even more because the risk of injury is higher.

• Time the seizure from the start.
• Roll the person onto their side when possible.
• Remove hazards, but do not restrain movements.

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06 · Seizures

When it is urgent, and when it can wait

Some seizure situations need emergency services right away, while others need prompt medical follow-up.

Call emergency services right away if the seizure lasts longer than 5 minutes, if another seizure starts before the person fully wakes, or if breathing does not return to normal. Emergency care is also important after serious injury, a head strike with ongoing symptoms, or seizure symptoms in pregnancy.

A first seizure should be evaluated promptly, even if it stops on its own. That does not always mean ambulance transport, but it does mean the person should be checked soon so the cause can be looked for and future risk can be discussed.

If the person is turning blue, not waking up, or having severe trouble breathing, do not wait for a clinic visit or try to monitor it at home.

• More than 5 minutes is an emergency threshold.
• Repeated seizures without recovery need urgent help.
• Pregnancy plus seizure symptoms is an emergency.

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07 · Seizures

How the cause is checked

The history, exam, and selected tests help separate seizure from a look-alike event and look for triggers.

After a first seizure, clinicians usually start with a careful history and physical exam. What the person did before, during, and after the event can be just as important as the event itself. Witnesses may notice staring, stiffening, rhythmic shaking, unusual sounds, tongue biting, injury, or a slow return to normal.

Brain scans and other tests may be ordered when the cause is not clear or when the story suggests a brain problem. Blood tests may also be used to look for possible triggers or related medical problems, but they are not always diagnostic by themselves. The exact workup depends on the person and the situation.

In pregnancy, blood pressure and urine testing matter because preeclampsia can lead to seizures and requires urgent treatment.

• Witness descriptions are often essential.
• Testing is individualized; there is no single standard panel for every person.
• Pregnancy changes the urgency and the workup.

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08 · Seizures

Treatment, follow-up, and safety planning

Treatment depends on the cause, seizure type, and how well the current plan is working.

If the seizure came from a reversible trigger, treatment may focus on fixing that trigger. If the person has epilepsy, medicines are commonly used to reduce or prevent future seizures. Which medicine fits best depends on the seizure type, other health conditions, other medicines, and life circumstances such as pregnancy.

Some people need more than medicine if seizures continue. Clinicians may discuss surgery, implanted devices, or special diets in some children when medicines are not working well. The goal is fewer seizures, fewer side effects, and a plan that fits daily life.

A seizure history also affects safety. Driving, bathing, swimming, heights, sleep, school, and work hazards may need review. A written seizure plan can help family members, school staff, or caregivers know what to do during an episode and when to call for help.

• Take seizure medicines exactly as prescribed.
• Do not stop a prescribed medicine suddenly without medical advice.
• Track patterns such as missed doses, poor sleep, illness, or alcohol use.

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09 · FAQ

Questions people ask

10 · References

References and supporting evidence

These sources support the points identified below. Source checking is not clinical approval.

1. S1: SeizuresMedlinePlus / U.S. National Library of Medicine

   Explains what a seizure is and why it can affect movement, awareness, speech, or behavior. Explains that seizures do not always look like shaking or dramatic convulsions. Supports the emergency threshold for prolonged or repeated seizures. Explains common temporary triggers and medical causes of a seizure.

2. S2: EpilepsyMedlinePlus / U.S. National Library of Medicine

   Defines epilepsy as recurring seizures rather than a single episode. Explains that evaluation can include brain scans and additional tests when epilepsy is being considered. Explains treatment goals and why medicine is often used.

3. S3: High Blood Pressure in PregnancyMedlinePlus / U.S. National Library of Medicine

   Supports urgent attention to seizure symptoms in pregnancy because preeclampsia can be dangerous. Explains the pregnancy/postpartum seizure danger the guide flags as an emergency.

General information, not a diagnosis. This guide is not a substitute for care from a qualified healthcare professional. For an emergency, call 911 in the US or your local emergency number. Illustrations are conceptual and are not diagnostic images.