Signs of a Seizure Coming On in Someone Else

Medically reviewed by Brigid Dwyer, MD

A seizure results from a temporary change in the brain's electrical function. When it occurs, a person affected by a seizure might appear to have abnormal muscle movements, unusual behavior, or lose consciousness.

Approximately 1 in 10 people may have at least one seizure during their lifetime. Seizures occur commonly enough that knowing seizure first aid can be beneficial.

This article discusses seizure signs in children and adults and what to do if someone around you is having a seizure.

Recognizing Early Signs of a Seizure

While you can't always prevent a seizure from happening, recognizing the early signs of a seizure in children and adults can help you ensure a safe environment and prepare to respond accordingly.

Babies and Children

Seizures in babies and children often occur in the first year of life. Epilepsy, is a brain disorder causing two or more seizures of any kind. It is the most common neurologic disorder diagnosed in babies and children.

Infants and children under six have immature nervous systems, so seizure activity is usually subtle. Signs of a seizure in this age group typically include:

• Flickering eyelids and forced eye deviation

• Leg bicycling

• Lip smacking
  

• Loss of head control or general loss of muscle tone
  

Seizures in children older than six typically resemble symptoms similar to seizure presentation in adults.

Adults

Seizures in adults typically fall into one of two groups: generalized or focal seizures. Generalized seizures affect both sides of the brain. The two subtypes of generalized seizures include:

• Absence seizures: A person affected by an absence seizure can appear to have rapid blinking or staring into space for a few seconds.

• Tonic-clonic seizures: A person affected by a tonic-clonic seizure might have muscle jerks or spasms, which cause them to fall to the ground or even lose consciousness.

Focal seizures occur in a specific brain area and can be classified as simple, complex, or secondary generalized seizures.

• Simple focal seizure: A person affected by simple focal seizures might experience twitching or a change in smell or taste.

• Complex focal seizure: A person affected by a complex focal seizure may become confused or dazed and unable to respond for several minutes.

• Secondary generalized seizures: A person affected by a secondary generalized seizure may first experience a focal seizure that spreads throughout the brain. Symptoms may start as twitching or a change in sensation and evolve into a generalized seizure.

Signs of a Seizure by Phase

Often, people who experience seizures go through four stages of the seizure process.

Prodromal Phase

During the prodromal phase, sense an impending seizure and experience changes in feelings hours or even days ahead of time. This phase does not cause a seizure, nor is it considered part of a seizure, but it can alert a person affected by seizures that a seizure is coming.

Although not everyone with seizures experiences the prodromal phase, it can allow those who do to follow their seizure treatment plan and take precautions to prevent injury.

Early Ictal (Aura) Phase

In the early ictal (aura) phase, a person affected by seizures might experience a change in feeling, sensation, thought, or behavior that typically occurs with a seizure. Some of the changes they might experience include:

• A change in smell, déja vu

• Vision loss or visual blurring

• Racing thoughts

• Anxiety or panic

• Unexpected pleasant feelings.

The person experiencing the aura might also have dizziness or lightheadedness, a headache, nausea, numbness, or tingling somewhere in the body.

Ictal (Middle) Phase

The ictal (middle) phase of a seizure is when the seizure activity begins. Symptoms depend on the type of seizure and include:

• Muscle tightening and shaking

• Rapid blinking
  

• Staring off into space

• Twitching

• Changes in sensation

• Appearing dazed and confused

Post-Ictal (End) Phase

When the seizure activity ends, the post-ictal (end) phase begins. The post-ictal phase is also known as the recovery phase. It may take minutes to hours for a person who experienced a seizure to recover and feel like themselves again.

How to Care for Someone With Seizure Signs

Seizure activity typically lasts for a few minutes. Some important things to assist a person affected by a seizure include:

• Assist the person to the ground to prevent falling during the seizure.

• Stay with the person until the seizure ends and they are awake and aware.

• Once the person is awake and aware, explain what occurred.

• Provide comfort and speak slowly and calmly.

• Keep everyone calm, including yourself.

• Gently help the person lie on one side and loosen any collars or ties to help keep the airways open.

• Prevent injury by clearing anything away that could be harmful, like sharp or hard objects.
  

Signs of Seizure After Effects

When a person who experiences seizures gets to the post-ictal (end) phase, it could take minutes to hours for them to feel like themselves again. Some of the common signs people experience after a seizure include:

• Experiencing a delayed response to questions

• Feeling sleepy or confused

• Having difficulty talking

• Feeling lightheaded or dizzy

• Feeling upset, sad, anxious, frustrated, or embarrassed

• Experiencing headaches or generalized muscle soreness or weakness

• Having an urge to use the bathroom (unless they lost bowel and bladder control during the seizure)

• Sustaining possible injuries, such as broken bones or a concussion, from tonic-clonic seizure activity or falling to the ground during the seizure

Reasons to Not Delay Medical Attention

In most cases, seizures end within a few minutes and often do not require medical attention. However, it is important to call 911 if any of the following occur:

• The seizure lasts more than five minutes.

• The person has never had a seizure before or had back-to-back seizures.

• The person has trouble breathing or difficulty waking up once the seizure ends.

• The person experiencing the seizure sustained an injury.

• The seizure occurs while the person is in the water.

• There is a known health condition like diabetes, heart disease, or pregnancy.

Related: Causes and Prevention of Seizures

Summary

Seizures are common, with approximately 10% of the population experiencing at least one seizure in their lifetime. The disruption of the nervous system's electrical activity can cause a variety of seizure symptoms. Most seizures last for a few minutes and do not require medical attention.

If you are with someone having a seizure, keep calm and stay with the person. Assist them to the ground, lay them on their side, and clear the area of any sharp or hard objects that could cause injury. If the seizure lasts longer than five minutes, or injury or difficulty breathing occurs during the seizure, call 911 for immediate medical assistance.

Read the original article on Verywell Health.