Introduction

A first seizure is a reason to visit your doctor or a hospital's emergency department. For a person with a seizure disorder, a change in seizure patterns or more frequent seizures are reasons to see your doctor.

Many people with recurrent seizures may have a seizure and awaken fully. Immediate medical attention is not often needed if the person is fully awake and has not suffered injury.

Other conditions, however, call for immediate medical attention.

• A seizure that continues more than 5 minutes or a series of seizures without full recovery between them
• Persistent breathing difficulty (Often the person may appear to stop breathing briefly during the seizure, but breathing should resume quickly.)
• Injuries sustained during a seizure
• Persistent confusion or unconsciousness
• A first seizure
• A significant change from that person's usual seizure pattern in terms of seizure type, seizure length, or associated symptoms

Home care is appropriate when a person is known to have seizures, if the seizure is brief, and if the person recovers uneventfully.

• Prevent injuries.
  • Cushion the head.
  • Loosen any tight neckwear.
  • Turn the person on his or her side after the convulsion ceases. This may help drain any moisture or secretions from the person's mouth.
  • Do not attempt to hold down or restrain the person.
  • Do not place anything in the person's mouth or try to pry the teeth apart.
  • Observe these items: length of seizure, type of movements, direction of any head or eye turning, amount of time to return to alertness and full consciousness.

Follow-up

Seizures are often continuing concerns. It is important to keep any follow-up appointments or tests.

• Until the seizures are well controlled, it is important to avoid driving or engaging in any other potentially dangerous activity that may cause you harm or harm to others if a seizure suddenly occurs.
• Many states require mandatory reporting of seizures to state drivers' license bureaus and other regulatory agencies.

Prevention

For many people with recurrent seizures, one key to prevention is taking prescribed medication on a regular basis.

• Failure to take antiseizure medications as prescribed is a common cause of recurrent seizures. Certain medical conditions or interaction with other medication can lead to temporary failure of the antiseizure medicine even if taken properly.
• If the cause of the seizure is discovered, it is important to treat that condition and address whatever caused the seizure

Outlook

The outlook for someone with seizures usually depends on the cause of the seizure. Investigation by a doctor is usually needed to discover the cause or at least exclude some causes.

• Most seizures related to medications, drugs, or minor head injury  , for example, resolve without specific treatments and do not indicate an ongoing seizure disorder or epilepsy  .
• Most other seizure disorders can be effectively managed with proper medications given under the guidance of your doctor or a specialist known as a neurologist.
• Some seizure disorders are difficult to control despite medications and other therapies. This situation is rare.
• A subclass of seizures is known as nonepileptic seizures or pseudoseizures. These are not truly epileptic seizures at all, but rather represent a condition in which someone has realistic-appearing seizures because of an underlying stress or psychological disorder. Prognosis for these is very good and is related entirely to resolving the person's underlying disorder with counseling, not antiseizure medications. This possibility should be considered in these cases:
  • When no cause of seizures can be found
  • If the seizures cannot be verified despite appropriate evaluation
  • If the seizures are resistant to appropriate medical therapies