Seizures in adults

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.

Recognition features

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.

Your aims

  • To protect the casualty from injury
  • To give care when consciousness is regained
  • To arrange removal of the casualty to hospital if necessary.

Treatment

  • 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.

Caution

  • Do not move the casualty unless they are in immediate danger.
  • Do not put anything in their mouth or use force to restrain them.

Warning

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.

Related topics

Please note:

These hints are no substitute for thorough knowledge of first aid! St John Ambulance holds first aid courses throughout the country.