What to do if someone around you has a seizure

A seizure is, to put it in simple terms, a kind of misfire in someone's brain. Abnormal electrical activity causes the body to react in ways that sometimes frighten onlookers.

There are a variety of different types of seizures, but two main categories: Generalized and Partial. Partial seizures begin in one side of the brain, while generalized seizures involve both sides of the brain.

Sometimes seizures are preceded by an aura, a recognizable sensation that always happens  before the person seizes. This early warning system can allow the person to tell others before the seizure starts. If someone seizes without warning, you will need to recognize the signs.

When people think of seizures they tend to picture Tonic Clonic (or grand mal) seizures. These seizures are characterized by loss of consciousness, groaning, muscle spasms, flailing or jerking limbs, biting of ones's tongue/cheeks, possibly a blue tint to the lips or skin, and sometimes loss of bladder/bowel control. Usually this type of seizure is followed by confusion and drowsiness.They are very scary looking and often cause people to overreact if they aren't prepared.

There is more than one kind of generalized seizure, and they don't all look the same. Absense seizures, for example, are visible in that the person becomes non-responsive and may blink repeatedly or roll up their eyes. Myoclonic seizures are short jerky movements of one or more limbs. Atonic seizures look as though the person has fainted, or lost use of their body though they remain conscious throughout. Tonic seizures are a stiffening of muscles that can cause the person to fall if they are standing up. Clonic seizures cause rhythmic jerking movements in either one or both sides of the body.

There are also three types of partial seizures. Simple Partial seizures also come in three forms, motor (consisting of abnormal repetitive movements, laughter, speech, or weakness), sensory (where the person smells, tastes, sees, feels, or hears thing that aren't there. These can range from pleasant to painful), autonomic (consisting of changes in autonomic functions which cause strange feelings in the stomach, chest, or head. Also changes in heart rate, or rate of breathing can occur, and this type of seizure might cause the person to sweat or get goosebumps), and psychic (which cause people to think, feel, or experience things, and can cause memory problems, garbled speech, trouble finding common words, an inability to understand spoken or written language, sudden feelings -such as fear or happiness-, and the feeling of deja vu).

Complex Partial seizures can be seen as a sort of deep day-dreaming state, sometimes accompanied by purposeless actions or words. The persons eyes will be open, and they might be moving, but 'no one will be home'. Sometimes these seizures manifest as blank staring,muttering or crying, other times as people picking at their clothing, or even stronger actions such as walking or getting undressed.

Secondary Generalized seizures basically consist of one of the types of partial seizures, followed by a tonic clonic seizure. It starts in one part of the brain, and spreads into the rest of the brain.

The first thing you need to do is stay calm . Keep in mind that most seizures, even most convulsive seizures, are not medical emergencies. So unless the seizure lasts more than five minutes, or is quickly followed by another seizure, there is no need to call an ambulance. Unless of course the person has injured themselves during their convulsions or continues to have trouble breathing, in those cases though you're calling the ambulance for the injury not the seizure itself.

Trust me when I say that the person who has the seizure will not thank you for an unnecessary hospital visit. So, keep calm and be watchful (of time especially- stick to the five minute rule). You might not need to call an ambulance, but you can still be helpful.

Let's start with what you don't do.

• Do not immediately call an ambulance (see above)
• Do not try to hold the person down. This can cause injury to both parties and is just a very bad idea. People who do this are usually trying to stop the person seizing from hurting themselves, but end up causing the opposite to happen. (There are exceptions of course, like if the person is about the convulse into a glass window)
• Do not put anything in the persons mouth. Nothing. Not a piece of wood. Not a belt. And definitely not your finger (unless you want to loose it). People who do this are usually under the misconception that the person can swallow their tongue, or that putting something in the persons mouth will stop them from biting their tongue or cheeks. It will not. All it will do is put the helper at risk. The person seizing will not, can not, swallow their own tongue. And if they are going to bite down, they are going to bite down, you can't change that.
• Do not splash them with water if they've lost consciousness. It won't wake them up, but it will make it so they wake up confused, embarrassed, and wet.
• Do not try to give the person water, food, or medication until they are completely awake and aware.
• Do not crowd around the person as they wake up. There are few things as embarrassing as waking up to a group of people staring down at you like you are a circus act. Trust me on this.

Now that we've covered what you shouldn't do. Let's move on to what you should do.

• Do remove any sharp, hard, or dangerous objects that the person might hurt themselves on.
• Do loosen tight or constricting clothing that might hinder the person's ability to breath.
• Do put something soft under the person's head.
• Do turn the person gently onto their side. This does two things: 1- it opens their airway and 2- it allows any fluids to drain (saliva, blood, etc).
• Do stay with the person until they have recovered.
• Do let the person rest where they are until they have recovered.
• Do be kind, supportive, and respectful to the person. They will likely be confused and embarrassed and will need reassurance.
• Do help them make any necessary arrangements, such as calling someone or getting a ride somewhere safe. 
• Do, if the person still isn't breathing once the seizure has stopped, start CPR.
• Do call an ambulance if the person has caused themselves serious injury (broken limbs, cuts, head injury) or if they continue to have trouble breathing.

So, the seizure is over. If the person ever fell or lost consciousness, they have since regained it. What happens now?

Many types of seizures don't require active care, and the person will return to normal as soon as the seizure ends.

Someone returning to consciousness after a seizure will usually be groggy, confused, and sleepy. Some people take only a few moments to recover from a seizure, others take hours. If it's the person's first seizure, they should head to a doctor. If not and they know they have a slow recovery time, what they need most is to get home and have a nice rest.