Epilepsy: Symptoms, First Aid for a Seizure and Treatment

A sudden fall, stiff limbs, jerking and a frightening loss of awareness. In many homes the first reaction is to call a spiritual healer, hold an onion or a shoe to the person’s nose, or force something into the mouth. These beliefs are common, and they are dangerous. Epilepsy is a medical condition of the brain, it is not caused by jinn or evil eye, it is not contagious, and in about 7 out of 10 people it can be controlled with regular medicine so that they live a normal life.

What is epilepsy?

Epilepsy is a tendency to have repeated seizures that start without an obvious trigger. A seizure is a sudden burst of abnormal electrical activity in the brain. One seizure does not mean you have epilepsy. A seizure caused by a high fever in a young child, low blood sugar or a head injury is different, although it needs a medical check.

Types of seizures

• Generalised tonic-clonic seizure: loss of consciousness, stiffening and then jerking of the whole body, sometimes with tongue biting or loss of bladder control. It lasts one to three minutes, followed by drowsiness and confusion.
• Absence seizure: a brief blank stare, usually in children, lasting a few seconds, often mistaken for daydreaming.
• Focal seizure: affects part of the brain. It can cause twitching of one arm, odd tastes or smells, a rising feeling in the stomach, fear or repeated movements like lip smacking, with or without awareness.

What causes epilepsy?

In about half of people no cause is found. Known causes include:

• Head injury, and brain injury at birth
• Stroke and brain tumours
• Infections of the brain such as meningitis, encephalitis and brain cysts from parasites
• Genetic conditions that run in families
• Developmental brain conditions

Fits in babies and young children with high fever are usually febrile seizures. See fever in children.

First aid for a seizure

1. Stay calm and note the time the seizure started.
2. Move hard or sharp objects away, and place something soft under the head.
3. Loosen tight clothing around the neck and remove glasses.
4. When the jerking stops, gently turn the person onto their side, in the recovery position, so that saliva and vomit drain out and they can breathe.
5. Stay with them until they are fully awake and talk to them calmly.

Never do these things:

• Put a spoon, finger, cloth or anything else in the mouth. It can break teeth and block the airway. The tongue cannot be swallowed.
• Hold the person down or try to stop the movements.
• Make them smell an onion, a shoe or a perfume. It does nothing and wastes time.
• Give water, food or medicine until they are fully awake.

Call an ambulance (for example Rescue 1122) if the seizure lasts longer than five minutes, if another one follows without recovery, if the person does not wake up, has trouble breathing, is injured or pregnant, is in water, or it is their first seizure.

Diagnosis

A neurologist asks for a detailed description of the episodes, often from a witness. A video on a mobile phone can be very helpful. An EEG records the brain’s electrical activity, and an MRI or CT looks for a cause.

Treatment

Daily anti-seizure medicines prevent seizures in most people. The choice depends on the seizure type, age, sex and other health problems. Commonly used medicines include levetiracetam, carbamazepine, oxcarbazepine, lamotrigine, valproate, phenytoin, topiramate and lacosamide.

• Take the tablets at the same times every day. A missed dose can trigger a seizure.
• Never stop or change the dose suddenly, even if you have been seizure-free for years. Stopping suddenly can cause a prolonged, dangerous seizure. Only the neurologist should decide to reduce.
• Keep a spare supply and refill early, so you never run out.
• Stick to the same brand where possible, and check with your doctor before switching brands.
• Some medicines, such as carbamazepine and phenytoin, can reduce the effect of birth control pills and interact with other medicines. Always tell any doctor or pharmacist that you take them.
• Women who might become pregnant should discuss treatment with their doctor early, because some epilepsy medicines, especially valproate, can harm the baby. Never stop them on your own. Folic acid is usually advised before and during pregnancy.
• Some people with seizures that do not respond to medicines benefit from surgery, a special diet or nerve stimulation.

Everyday life with epilepsy

• Sleep regularly, because lack of sleep is a common trigger.
• Avoid alcohol and recreational drugs.
• Manage stress and illness, and take your tablets even when unwell.
• Take showers instead of baths, avoid swimming alone, and take care around open flames, heights and traffic.
• Follow your doctor’s advice about driving and work.
• Tell teachers, employers and family, so they know what to do. Most children with epilepsy can go to school and play normally.
• Do not hide the condition because of stigma. It is common, and it is treatable.

Key takeaways

• Epilepsy is a medical condition and can be controlled with regular medicine in most people.
• During a seizure, protect the head, turn the person on their side, and put nothing in the mouth.
• Call an ambulance if a seizure lasts more than five minutes or does not stop.
• Never stop epilepsy medicines suddenly, and never run out.

Related medicines on Medimart

These are commonly prescribed by neurologists for epilepsy:

• Levetiracetam: a widely used anti-seizure medicine
• Carbamazepine: used for focal and generalised seizures
• Oxcarbazepine: a related medicine with fewer interactions
• Lamotrigine: used for several seizure types
• Valproate: broad-spectrum, with special cautions for women
• Phenytoin: an older anti-seizure medicine
• Topiramate: used alone or with other medicines
• Lacosamide: used for focal seizures
• Folic acid: advised before and during pregnancy

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse epilepsy medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If you or your child has had a seizure, please see a doctor.