In first-aid, seizures are often grouped into three categories.
Febrile seizure (or convulsions)
Absence seizures
Convulsive seizures
Febrile seizure
A febrile seizure is a fit that can happen when a child has a fever. They are relatively common and, in most cases, are worrying to see; however, they aren’t severe. Around one in 20 children will have at least one febrile seizure at some point. They most often occur between the ages of six months and three years.
During a febrile seizure, the child’s body usually becomes stiff, losing consciousness, and their arms and legs twitch. Some children may wet themselves.
Why febrile seizures occur
The cause of febrile seizures is unknown, although they’re linked to the start of a fever (a high temperature of 38C (100.4F) or above).
In most cases, a high temperature is caused by an infection such as:
There may also be a genetic link to febrile seizures because the chances of having a seizure are increased if a close family member has a history of them. Around one in four children affected by febrile seizures has a family history.
What to do during a seizure
If a child is having a febrile seizure, remove clothing to cool them down, and place them in the recovery position. Lay them on their side, on a soft surface, with their face turned to one side. This will stop them from swallowing any vomit, keep their airway open and help prevent injury.
Stay with your child and try to make a note of how long the seizure lasts.
If it’s your child’s first seizure or it lasts longer than five minutes, take them to the nearest A&E as soon as possible, or dial 999 for an ambulance. While it’s unlikely that there is anything seriously wrong, it is best to be sure.
If your child has had febrile seizures before and the seizure lasts for less than five minutes, phone your GP or the NHS 111 service for advice.
Please don’t put anything, including medication, in your child’s mouth during a seizure because there’s a slight chance that they might bite their tongue.
Almost all children make a complete recovery after having a febrile seizure.
Absence seizure
Typical absences
If a casualty has a typical absence seizure, they will suddenly stop what they are doing for a few seconds but will not fall. The person might appear to be daydreaming or ‘switching off’. People around might overlook the absence seizure.
Your eyelids might flutter and have slight body jerking movements or limbs. In longer absences, you might have some short, repeated actions. You won’t know what is happening around you and can’t be brought out of it.
Some people have hundreds of absences a day. They often have them in clusters, one after another, and they are often worse when they wake up or drift off to sleep. Typical absence seizures almost always start in childhood or early adulthood.
When an absence seizure ends, the person usually continues doing what they were doing before the seizure. They are almost always wide awake and able to think clearly. Generally, no first aid is needed for this type of seizure.
Convulsive seizures
If you see someone having a seizure or fit, there are some simple things you can do to help. It might be scary to witness, but do not panic.
If you’re with someone having a seizure:
- only move them if they’re in danger, such as near a busy road or a hot cooker
- if safe to do so, cushion their head if they’re on the ground
- loosen any tight clothing around their neck, such as a collar or tie, to aid breathing
- place them in the recovery position after their convulsions stop if they are not conscious
- stay with them and talk to them calmly until they recover
- note the time the seizure starts and finishes
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.
Please do not put anything in their mouth, including your fingers. They should only have food or drink once they have fully recovered.
When to call an ambulance
Call 999 and ask for an ambulance if:
- it’s the first time someone has had a seizure
- the seizure lasts longer than is usual for them
- the seizure lasts more than 5 minutes, or if you do not know how long their seizures usually last
- the person does not regain full consciousness or has several seizures without regaining consciousness
- the person is seriously injured during the seizure
People with epilepsy do not always need an ambulance or to go to the hospital every time they have a seizure.
Some people with epilepsy wear a unique bracelet or carry a card to let medical professionals and anyone witnessing a seizure know they have epilepsy.
Make a note of any helpful information.
If you see someone having a seizure, you may notice things that could be useful for the person or their doctor to know:
- What were they doing before the seizure?
- Did the person mention any unusual sensations, such as odd smells or tastes?
- Did you notice any mood changes, such as excitement, anxiety, or anger?
- What brought your attention to the seizure? Was it a noise, such as a person falling over, or body movements, such as their eyes rolling or head turning?
- Did the seizure happen without warning?
- Was there any loss of consciousness or altered awareness?
- Did the person’s colour change? For example, did they become pale, flushed, or blue? If so, where – the face, lips, or hands?
- Did any parts of their body stiffen, jerk or twitch? If so, which parts?
- Did the person’s breathing change?
- Did they perform any actions, such as mumble, wander about or fumble with clothing?
- How long did the seizure last?
- Did the person lose control of their bladder or bowel?
- Did they bite their tongue?
- How were they after the seizure?
- Did they need to sleep? If so, for how long?
