A seizure - also called a convulsion or fit - consists of involuntary contractions of many muscles in the body.
The condition is due to a disturbance in the electrical activity of the brain. Seizures usually result in loss or impairment of consciousness.
The most common cause is epilepsy. Other causes include:
- Head injury
- Some brain damaging diseases
- Shortage of oxygen or glucose in the brain
- The intake of certain poisons including alcohol.
Epileptic seizures are due to recurrent, major disturbances of brain activity. These seizures can be sudden and dramatic. Just before a seizure, a casualty may have a brief warning period (aura) with, for example, a strange feeling or a special smell or taste.
No matter what the cause of the seizure, care must always include maintaining an open, clear airway and monitoring the casualty's vital signs - level of response, pulse and breathing. You will also need to protect the casualty from further harm during a seizure and arrange appropriate aftercare once they have recovered.
General recognition features are:
- Sudden unconsciousness
- Rigidity and arching of the back
- Convulsive movements.
In epilepsy the following sequence is common:
- The casualty suddenly falls unconscious, often letting out a cry.
- They become rigid, arching his back.
- Breathing may cease. The lips may show a grey-blue tinge (cyanosis) and the face and neck may become red and puffy.
- Convulsive movements begin. The jaw may be clenched and breathing may be noisy. Saliva may appear at the mouth and may be blood-stained if the lips or tongue have been bitten. There may be loss of bladder or bowel control.
- Muscles relax and breathing becomes normal; the casualty recovers consciousness, usually within a few minutes. They may feel dazed or act strangely. They may be unaware of their actions.
- After a seizure, the casualty may feel tired and fall into a deep sleep.
- To protect the casualty from injury
- To give care when consciousness is regained
- To arrange removal of the casualty to hospital if necessary.
- If you see the casualty falling, try to ease the fall
- Make space around them; ask bystanders to move away.
- Remove potentially dangerous items, such as hot drinks and sharp objects
- Note the time when the seizure started
- If possible, protect the casualty's head by placing soft padding underneath it
- Loosen clothing around the neck.
When the seizure has ceased
- Open the airway and check breathing
- Be prepared to give rescue breaths and chest compressions.
- Place them into the recovery position if the casualty is unconscious but breathing normally
- Monitor and record vital signs - level of response, pulse and breathing
- Note the duration of the seizure.
- Do not move the casualty unless they are in immediate danger.
- Do not put anything in their mouth or use force to restrain them.
If any of the following apply, dial 999 for an ambulance.
- The casualty is unconscious for more than 10 minutes.
- The seizure continues for more than 5 minutes.
- The casualty is having repeated seizures or having their first seizure.
- The casualty is not aware of any reason for the seizure.