First Seizure - Advice sheet for adult patients

What happens during a seizure?

There are different types of seizure. It is helpful to understand the seizure types and the various signs and symptoms.

Tonic-clonic seizure

This is the most common type of seizure and the easiest to identify.

The muscles contract forcing the air out of your lungs, your body stiffens and then jerks uncontrollably. Because of the muscles contracting you may let out a cry as you fall down unconscious. For the same reason, you may bite your tongue, be unable to swallow saliva normally, or be incontinent. Your breathing may be irregular; your face may look very pale with a bluish tinge around the lips due to lack of oxygen. The jerking movements nearly always slow down and then stop within five minutes.

A period of drowsiness, confusion, headache and sleep often follows. When you come round you cannot remember what has happened. Recovery time varies.

Absence seizure

You stop what you are doing, stare, blink or look vague for a few seconds before carrying on with what you were doing. An onlooker may simply think you are day dreaming or may not even notice, although you may experience many absences a day.

If you suffer further seizures you may have to undergo investigations which include a Brain scan, (EEG), blood tests and treatment.

Now that you have been discharged from hospital, you need to be aware of your own safety and that of others. There are certain things that you must do.

• If you are a driver, you must not drive and you are legally obliged to inform the DVLA about your seizures. They may ban you from driving for a year. You must also inform your insurance company.
• Do not operate dangerous machinery.
• Avoid working on heights
• If you go swimming, always make sure someone comes with you and you inform the lifeguard.
• Take a shower instead of a bath
• Avoid taking excessive amounts of alcohol
• Avoid sleep deprivation
• Ensure that you have regular meals to maintain your energy levels

In the event of a further seizure, this is what the people around you need to do:

• Stay calm.
• Loosen any tight clothing around your neck.
• Protect you from injury (remove sharp or hard objects from the vicinity; or guide you away from danger.
• Cushion your head if you fall down.
• Once the seizure has finished, they may aid your breathing by gently placing you on your side (known as recovery position as shown below) if you have fallen.

• Stay with you until you come round and are fully recovered.
• Be quietly reassuring.
• Following your recovery, inform your doctor that you have had a second or subsequent seizure. Subsequent seizures may mean that you require further investigations and/or treatment.

Other generalised seizures

In Atonic seizures (drop attacks), the muscles suddenly lose their tone causing you to fall heavily to the ground. In Myoclonic seizures, you have brief forceful jerks, similar to those many of us experience as we drop off to sleep.

Simple partial seizures

Abnormal jerking or twitching, numbness, pins and needles, sweating, dizziness, nausea, disturbance of perception and memory such as hearing, vision, smell or taste, things seeming larger or smaller, or feeling that you have been somewhere before (déjà vu) are examples of what you may feel, but there are many others. These may last for several seconds or minutes.

Simple partial seizures can progress to complex partial seizures or to a generalised seizure. When this happens, these early symptoms can serve as a warning and are known as an aura.

Complex partial seizures

You may behave strangely: you may pluck at your clothes, fumble with buttons, smack your lips, swallow repeatedly, or wander around as if drunk. Such actions are known as automatisms. From time to time they take more unusual forms for instance, some people may undress or behave affectionately to complete strangers.

Status Epilepticus

This is a prolonged seizure or a series of seizures that happen without recovery in between. It is requires urgent medical attention.

Who do I go to for further information

If you have further questions the please contact: epilepsy nurse specialist

Telephone: 01223 217992

Pager: 07623 615181