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Epilepsy: First Aid for a Seizure and Living with the Condition

How to help someone during a seizure, when to get emergency care, which doctor to see, and how people with epilepsy in Bangladesh can live safely.

Seeing someone have a seizure can be frightening. Most seizures do not need emergency care. The most useful thing you can do is stay calm and keep the person safe. This guide explains what epilepsy is, how to give seizure first aid, when to get emergency help, and how people with epilepsy can live safely.

What is epilepsy?

A seizure (often called a fit, or khichuni) is a short burst of abnormal electrical activity in the brain. It can cause jerking movements, stiffness, staring, confusion or loss of awareness. Epilepsy is a long-term brain condition. The World Health Organization (WHO) says a person has epilepsy when they have had two or more unprovoked seizures. Unprovoked means there was no clear short-term cause for the seizure. One example of a seizure with a clear cause is a seizure with a high fever in a young child. Having one seizure does not mean a person has epilepsy.

Sometimes a brain scan finds a problem that can cause epilepsy, such as damage from a stroke, scarring or a growth. However, tests do not always find a cause. WHO estimates that about a quarter of epilepsy cases could be prevented. WHO describes epilepsy as a noncommunicable disease, which means it does not spread from person to person.

How common is it in Bangladesh?

The first national epilepsy survey in Bangladesh was carried out from January to May 2017 by the National Institute of Neurosciences and Hospital with WHO. WHO published the results in June 2018. The survey found about 8.6 people with epilepsy for every 1,000 people. The most common type was the generalised tonic-clonic seizure, in which the person becomes unconscious and their body stiffens and jerks.

According to the same 2017 survey, about 9 out of 10 people with active epilepsy were not getting appropriate treatment. This matters because epilepsy can be treated. WHO says up to 70% of people with epilepsy could become seizure-free if they are properly diagnosed and treated.

First aid during a seizure

These steps are based on guidance from the US Centers for Disease Control and Prevention (CDC) and the UK National Health Service (NHS):

  1. Stay calm and stay with the person. Keep other people from crowding around.
  2. Note the time the seizure starts and ends. A phone clock is fine.
  3. If they are falling, help them to the ground gently.
  4. Move away anything hard or sharp nearby, such as furniture or tools. Only move the person if they are in danger, for example near a road or a hot stove.
  5. Put something soft and flat under their head, such as a folded scarf, orna or jacket.
  6. Remove glasses and loosen anything tight around the neck.
  7. Turn them gently onto their side with the mouth pointing down. This keeps the airway (the breathing passage) clear. The NHS advises doing this once the jerking has stopped.
  8. Check for a medical bracelet or card with information about their condition or an emergency contact.
  9. After the seizure, stay with them, talk calmly and explain what happened. People often feel confused or very tired afterwards.

If the person is in a wheelchair, put the brakes on and leave any seatbelt or harness on. Support them gently and cushion their head, but do not try to move them.

What NOT to do

  • Do not hold them down or try to stop the movements. This could injure them or you.
  • Do not put anything in their mouth, including your fingers. A person having a seizure cannot swallow their tongue, and objects can hurt the teeth or jaw.
  • Do not give food, water or anything else by mouth until they are fully awake and alert.
  • Do not give mouth-to-mouth breaths during the seizure. People usually start breathing again on their own afterwards.

Useful things to remember for the doctor

Your description can help a doctor make a diagnosis. Try to note what the person was doing just before, whether they mentioned anything unusual (such as an odd smell or taste), which parts of the body stiffened or jerked, whether their lips or face changed colour, how long it lasted, and how they were afterwards. The NHS says a video recording of a seizure can also help, if it is safe to make one and the family agrees.

Warning signs: when to get emergency help

Seizures do not usually need emergency care, and people with epilepsy do not always need to go to hospital after a seizure. Get urgent medical help and take the person to the nearest hospital emergency department if:

  • the seizure lasts longer than 5 minutes, or longer than is usual for that person
  • it is the first seizure the person has ever had
  • another seizure starts soon after the first, or they have several seizures without waking up in between
  • they have trouble breathing or do not wake up properly afterwards
  • they are injured during the seizure
  • the seizure happened in water (for example a pond, river, bath or pool)
  • the person is pregnant, or has another health condition such as diabetes or heart disease

A seizure that lasts a long time, or a series of seizures without the person waking up in between, is called status epilepticus. It is a medical emergency and needs treatment as soon as possible. If a seizure has not stopped after 5 minutes, get emergency help straight away.

For non-urgent health advice from a doctor at any time, you can call the government health helpline Shasthyo Batayon on 16263. It runs 24 hours a day and can also give you information about the nearest government or private hospital.

How epilepsy is diagnosed

You will usually see a neurologist, who will want to know what happened before, during and after the seizure. They may suggest tests such as:

  • EEG (electroencephalogram): small sensors are attached to the scalp to record the brain’s electrical activity. If the EEG does not show anything unusual, it is still possible to have epilepsy.
  • Brain scans such as MRI or CT, to look for a problem in the brain.
  • Blood tests.

Sometimes epilepsy is diagnosed from the symptoms alone, even when the tests are normal.

Treatment

Treatment helps most people with epilepsy have fewer seizures or stop having them altogether. The main treatment is anti-seizure medicines, prescribed by a doctor. Other options a specialist may consider include surgery to remove a small part of the brain that is causing the seizures, a small electrical device placed inside the body, or a special diet (the ketogenic diet).

Missing doses of medicine, or stopping medicine suddenly, can make seizures more likely. If you have any questions or concerns about your epilepsy medicine, talk to your doctor.

Which doctor to see

Situation Who to see
Emergency or seizure lasting over 5 minutes Hospital emergency department
First seizure in an adult, or diagnosis and long-term care Neurologist (a specialist in brain and nerve conditions)
Seizures in a baby or child Paediatric neurologist (child brain specialist), or a paediatrician first
Seizures that are not controlled despite treatment Neurologist with an epilepsy service; sometimes a neurosurgeon
Planning pregnancy or pregnant Your neurologist together with an obstetrician (pregnancy doctor)
Low mood, anxiety or stress Psychiatrist or clinical psychologist

A general physician (medicine specialist) or your local doctor can often start the process and refer you to a neurologist.

Living well with epilepsy

Know your triggers

Triggers are things that make a seizure more likely. Common ones include missed medicine doses, lack of sleep, stress, being unwell with a high temperature, alcohol and missed meals. Keeping a seizure diary (date, time, what you were doing, how you felt) can help you and your doctor.

Stay safe at home and outdoors

  • Do not swim alone. Swim only with someone who knows you have epilepsy.
  • A shower is safer than a bath. Do not lock the bathroom door.
  • Take extra care near cooking fires, stoves and hot water.
  • Wear a helmet when cycling.
  • Avoid unprotected heights and moving machinery.
  • Carry a card or wear a bracelet with your diagnosis and an emergency contact.

Driving

Seizures while driving can be dangerous for you and others. Ask your doctor whether it is safe for you to drive, and check the licensing rules that apply to you.

Women, pregnancy and family life

Many women with epilepsy have straightforward pregnancies and healthy babies. However, some epilepsy medicines carry risks for an unborn baby. If you are planning a pregnancy, talk to your doctor or epilepsy specialist before you try to conceive. If you find out you are pregnant, speak to your doctor or specialist as soon as possible.

School and work

Most people with epilepsy can live normal lives if their seizures are well controlled. Most children with epilepsy can go to a mainstream school and take part in most activities, and can get a job when they are older. Tell teachers, employers and close family how to give seizure first aid.

A rare but serious risk

Rarely, a person with epilepsy dies suddenly without a clear cause. This is called SUDEP (sudden unexpected death in epilepsy). In adults with epilepsy, it typically affects about 1 in 1,000 people each year. Generalised tonic-clonic seizures are the greatest known risk factor. Talk to your doctor about how to keep your seizures as well controlled as possible.

Key points

  • Stay calm, time the seizure, cushion the head and turn the person onto their side.
  • Never put anything in their mouth or hold them down.
  • Get emergency help if a seizure lasts over 5 minutes, if it is a first seizure, or if the person does not wake up properly, has trouble breathing or is injured.
  • See a neurologist for diagnosis and treatment. With the right treatment, up to 70% of people with epilepsy could become seizure-free.

Sources

Find a doctor

Browse Neurology doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.

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