Epilepsy: Living Well and What to Do During a Seizure

What to do when someone has a seizure

• Stay calm and note the time the seizure started
• Clear the area of hard or sharp objects
• Place something soft under the head
• Turn the person onto their side once the jerking stops, to keep the airway clear
• Loosen tight clothing around the neck
• Stay with them until they are fully alert
• Speak calmly and reassure them — confusion afterwards is normal and can last several minutes

What never to do

• Never put anything in the mouth — a spoon, cloth, key or finger. Swallowing the tongue is impossible, and objects break teeth and block the airway
• Never restrain the limbs or try to stop the movements
• Never give water, medicine or food until the person is fully alert
• Never make the person smell an onion, shoe or iron — these do nothing
• Never crowd around the person

Living with epilepsy

The single most important factor in staying seizure-free is taking medication consistently at the same times each day. Missed doses are the commonest cause of breakthrough seizures. Use a pill box, phone alarms and a repeat prescription reminder — whatever makes it automatic.

Sleep deprivation, alcohol, fever and irregular medication are the main provoking factors. Most other restrictions people impose on themselves are unnecessary: with controlled seizures, people work, study, marry, have children and live entirely ordinary lives.

Practical safety

• Shower rather than bathe in a filled tub, and never lock the bathroom door
• Do not swim alone
• Avoid working at height or with unguarded machinery until seizures are controlled
• Driving requires a seizure-free period — check current regulations with your neurologist
• Carry a card or wear a bracelet stating your diagnosis and medication
• Inform close colleagues or classmates what to do — it removes fear on both sides

Epilepsy and pregnancy

Most women with epilepsy have normal pregnancies and healthy babies, but the pregnancy should be planned. Some anti-epileptic drugs carry a higher risk of birth defects, and switching needs to happen before conception, not after. High-dose folic acid is started well before pregnancy.

Never stop anti-epileptic medication on discovering a pregnancy. Uncontrolled seizures pose a greater risk to both mother and baby than most medications do. Speak to your neurologist immediately instead.