Epilepsy: understanding seizures, first aid and everyday support

Sultan AlmuhasinMedical review: Tatmeen teamUpdated 30 October 20267 min read

Article contents

What to do during a seizure
Does every seizure mean epilepsy?
Treatment: seizure control and an individual plan
Support that protects safety and dignity
Frequently Asked Questions
Sources and references
Writer and reviewer

A seizure may involve shaking and a fall, but it can also appear as a brief loss of responsiveness¹ or an unusual sensation. People living with epilepsy and those around them need to understand their particular seizures and the plan for responding. Epilepsy is a neurological condition that is not contagious². A diagnosis is no reason to exclude someone from education, work or relationships.

If someone is having a seizure now, protect them from injury and note the start time. Call an ambulance if it is their first seizure, lasts longer than is usual for them, reaches five minutes, repeats without recovery, or is followed by difficulty breathing. Also call for three or more seizures in 24 hours, even if they recover between them. In Saudi Arabia, call 997. Their medical plan may require an earlier call³.

What to do during a seizure

If the person falls and starts convulsing, move nearby hazards away³ and put something soft under their head. Move the person only if their location is dangerous. Stay with them and time the seizure⁴. Do not hold their limbs to stop the movements or put anything in their mouth, including your fingers.

When the convulsions stop, if they are breathing normally, gently turn them onto their side⁴ and stay until they recover. Speak calmly and explain what happened. Do not offer food or drink³ until they are fully alert. If a seizure involves confusion or wandering without convulsions, help them away from danger without restraining them.

A quick reminder for someone helping

During the seizure	After the convulsions stop
Note the time and clear hazards.	Check responsiveness and breathing.
Cushion the head; do not restrain the body or put anything in the mouth.	If breathing is normal, gently turn them onto their side.
Stay and call an ambulance for the warning signs above.	Stay; wait for full recovery before offering food or drink.

If an adult remains unresponsive after the movements stop, call an ambulance immediately and check their breathing. If they are not breathing normally, or only gasping, start chest compressions and follow the call handler's instructions. Do not wait for the ambulance to arrive. If an automated external defibrillator⁶ (AED) is available, switch it on and follow its prompts. Do not delay the call or CPR to search for one.

An ambulance is also needed for a serious injury, a seizure in water³, a seizure during pregnancy, or diabetes with loss of consciousness. Someone with known epilepsy may not need an ambulance for every seizure. Follow their emergency care plan⁴ if you know it and are trained to carry it out. Prescribed rescue medicine is given according to that plan; do not choose a medicine or dose yourself.

Does every seizure mean epilepsy?

If a suspected first seizure has ended without medical assessment, or seizures return after a long seizure-free period, contact a doctor for urgent assessment¹. Do not wait for that contact when the ambulance triggers above apply.

One seizure alone does not establish the diagnosis. There may be other causes. A doctor needs to know what happened before, during and after the event. Depending on the circumstances, assessment may include an electroencephalogram¹ (EEG), a heart tracing (ECG), blood tests or imaging. A witness's description can help.

Seizures do not all look alike. They may involve staring without responding¹, involuntary movements or changes in sensation, with consciousness preserved or affected. Classifying the seizure helps the doctor choose treatment, but a single symptom cannot establish its type.

You do not need to memorize seizure categories⁷. Ask your doctor to explain your seizure type¹, what it looks like, why it matters for treatment and what people around you should do. That information is more useful than trying to classify a seizure yourself.

Treatment: seizure control and an individual plan

Anti-seizure medicines are the main treatment for many people. The doctor chooses treatment according to the seizure type and the person's circumstances. The plan may need adjusting if seizures continue or side effects are troublesome. Do not suddenly stop your medicine or change the dose yourself. Abrupt withdrawal can lead to dangerous seizures⁸.

When starting or changing a dose of anti-seizure medicine, avoid driving and tasks requiring full alertness¹⁰ until you know how it affects you. Ask your doctor whether driving is safe for your situation¹ and about the applicable local requirements; feeling free of drowsiness alone does not establish fitness to drive.

If seizures continue despite treatment, speak to a neurologist or epilepsy specialist. Other options, including surgery or stimulation devices⁸, may suit some people, but eligibility needs individual assessment. Better seizure control does not automatically make medicine unnecessary, and there is no fixed recovery timeline that applies to everyone.

Tell your care team about any other medicine, supplement or herb⁹ you are considering. If you are planning pregnancy or become pregnant while taking epilepsy treatment, contact your specialist¹ to review the plan. Do not stop treatment yourself.

Support that protects safety and dignity

Agree with the person what those close to them should know: their usual seizure pattern, when to call an ambulance⁴, whom to contact and where to find their emergency plan. A medical ID card¹ can carry important information. Sharing what is needed for safety does not mean sharing every detail with everyone.

Fear of another seizure or embarrassment after a seizure in public may be difficult to live with. Anxiety and depression can accompany epilepsy². Discuss these concerns with the care team instead of assuming they must simply be endured. Psychological and social support⁹ can sit alongside neurological care.

Instead of saying, “Avoid everything so you don't get tired,” ask, “What help would let you take part safely?” Agree appropriate precautions with the care team for activities involving water, heat or heights¹. Record seizure times and descriptions⁹, and any problems with treatment, to discuss at appointments. Make continuing education, work and activities they enjoy part of the plan.

Frequently Asked Questions

What should I do if someone has a seizure in front of me?

Protect them from injury and note the start time. If they fall and start convulsing, move nearby hazards away and put something soft under their head; move them only if their location is dangerous. Stay with them and time the seizure. Do not hold their limbs to stop the movements or put anything in their mouth, including your fingers. When the convulsions stop, if they are breathing normally, gently turn them onto their side and stay until they recover.

When should I call an ambulance for a seizure?

Call an ambulance if it is their first seizure, lasts longer than is usual for them, reaches five minutes, repeats without recovery, or is followed by difficulty breathing. Also call for three or more seizures in 24 hours, even if they recover between them, and for a serious injury, a seizure in water, a seizure during pregnancy, or diabetes with loss of consciousness. In Saudi Arabia, call 997. Their medical plan may require an earlier call.

What if the person does not respond after a seizure?

If an adult remains unresponsive after the movements stop, call an ambulance immediately (997 in Saudi Arabia) and check their breathing. If they are not breathing normally, or only gasping, start chest compressions and follow the call handler's instructions. Do not wait for the ambulance to arrive. If an automated external defibrillator (AED) is available, switch it on and follow its prompts, without delaying the call or CPR to search for one.

Does one seizure mean I have epilepsy?

One seizure alone does not establish the diagnosis; there may be other causes. A doctor needs to know what happened before, during and after the event, and assessment may include an electroencephalogram (EEG), a heart tracing (ECG), blood tests or imaging, depending on the circumstances. If a suspected first seizure has ended without medical assessment, contact a doctor for urgent assessment. A witness's description can help.

Can I stop epilepsy medicine once my seizures are under control?

Do not suddenly stop your medicine or change the dose yourself; abrupt withdrawal can lead to dangerous seizures. Better seizure control does not automatically make medicine unnecessary. The doctor chooses treatment according to the seizure type and your circumstances, and the plan may need adjusting if seizures continue or side effects are troublesome. If seizures continue despite treatment, speak to a neurologist or epilepsy specialist.

Writing and article review

Written bySultan Almuhasin

Content writer and researcher at Tatmeen, working on Arabic and English articles across mental health and everyday life topics, including relationships, stress, work, habits, and family.

Medical reviewTatmeen team

Every Tatmeen article is reviewed by care providers licensed by the Saudi Commission for Health Specialties, so what you read is accurate and trustworthy.

This article builds understanding and does not replace a licensed care provider.

In immediate danger?

If you or someone you know is in danger, call an ambulance on 997 or go to the nearest emergency department.

Emergency numbers