A seizure is essentially an “electrical short circuit” in the brain. Irregular electrical activity causes the body to contract, shake, and lose control. This can happen due to epilepsy (the “falling disease”), but it is also very common in infants and toddlers due to a rapid rise in fever (“febrile seizure”), and sometimes due to heatstroke, dehydration, or head trauma.
The appearance is dramatic: Rolling eyes, clenched jaws, foam from the mouth, full-body shaking, and loss of consciousness. Most seizures end on their own within a few minutes and do not cause brain damage, provided we protect the person from external injury.
Debunking the most dangerous myth of all
For generations, we were told that a person having a seizure might “swallow their tongue” and therefore their mouth must be forced open. This is a life-threatening mistake. Anatomically, it is impossible to swallow the tongue. It is attached to the jaw. Attempting to shove fingers, spoons, wallets, or pens into the mouth of a person having a seizure causes severe harm: Broken teeth that are inhaled into the lungs and cause choking, torn gums, and danger to the caregiver’s fingers, which may be bitten by a jaw that clamps down with tremendous force. The rule: Do not put anything into the mouth of a person having a seizure.
So what should be done? Treatment protocol
- Removal: Move sharp objects, furniture, glass, or anything the person could hit during the shaking away from the person.
- Head cushioning: Place a pillow, folded jacket, or your hands under their head to prevent head injuries from the hard ground.
- Timing and calling for help: Look at the clock. The duration of the seizure is critical for medical treatment. Call 101 for MDA and put the phone on speaker.
- Do not restrain: Do not try to hold the arms or legs down by force to stop the shaking. It will not help and may cause fractures or muscle tears. Let the seizure pass.
After the seizure
When the shaking stops, the person will usually be unconscious, very confused, or drowsy (“unconscious and breathing”). Gently roll the person onto their side (recovery position). This allows secretions, saliva, or vomit to come out and not block the airway. Airway blockage by the base of the tongue (tongue collapse) is also prevented in this position. If the seizure occurred in a public place, try to move onlookers away. The person may wake up after losing control of their sphincters, which can be very embarrassing.
When is it truly dangerous?
Most seizures stop within 2 or 3 minutes. A critical emergency condition (Status Epilepticus) is defined as a seizure lasting 5 minutes or more, or a series of seizures without regaining consciousness in between. In this situation, the risk of brain damage increases significantly, and the arrival of an intensive care ambulance is extremely urgent.