Seizures (fits): Information for patients and carers

Seizures happen when there is a sudden burst of unusual electrical activity in the brain.

They can make someone become unresponsive, shake or jerk, become incontinent of urine, stiffen, or behave in an unusual way. 

Seizures can look different from person to person. This might include:

• shaking, jerking or stiffening of the arms, legs, face or body ( grand mal fit)
• suddenly becoming unresponsive, staring blankly or rolling the eyes
• new confusion, restlessness or unusual behaviour without shaking (non convulsive seizure)
• repeated movements such as lip-smacking or fumbling

Sometimes there may be a warning beforehand such as an odd feeling, a strange taste or smell, or a change in mood (aura).

People are often incontinent of urine during a grand mal seizure.

• try to stay calm and note the time it starts and finishes
• keep them safe. Move anything hard or sharp out of the way and put something soft under their head. Loosen anything tight around their neck
• do not put your fingers or anything else in their mouth, and do not try to hold them still
• if you have been given a emergency medicine (for example one given into the cheek) use it as instructed
• once the movements stop, gently roll them onto their side (the recovery position) so they can breathe easily. Do this sooner if they are being sick or bleeding from the mouth or nose
• stay with them and speak calmly. They may be confused or sleepy afterwards, which is normal
• don't give any food or drink until they are fully recovered and can swallow safely

• it is their first ever seizure
• the seizure lasts more than 5 minutes, or longer than is usual for them
• one seizure follows another without them waking up in between
• they are having trouble breathing, or their lips or face look blue
• they are injured during the seizure
• there is no one confident to manage the seizure

Tell the 999 handler if the person has an urgent care plan - this may help avoid an unwanted hospital admission.

• stay with the person until they are fully awake or settled into a normal sleep
• if you can, write down the time the seizure started and stopped and what you saw 
• tell the person's GP or specialist nurse, even if no treatment was needed - they may want to review medicines

• if the person takes a regular medicine to prevent seizures (anticonvulsants), it's important they take it at the same time every day and not to stop suddenly
• if there is trouble swallowing, tell the team straight away. The medicine can usually be given in another way e.g. by liquid, injection or a syringe pump
• some medicines can affect mood or behaviour. If you notice a change such as irritability, mention it - there are often alternative medicines