Seizures: causes, symptoms, types, first aid, triggers and prevention

A seizure can be frightening to witness, especially when someone suddenly falls, becomes unresponsive or starts jerking uncontrollably. But seizures do not always look dramatic. Some people may simply stare blankly for a few seconds, become confused, experience unusual sensations or make repetitive movements.

Understanding what a seizure looks like and knowing what to do can make a real difference. Just as importantly, a seizure does not automatically mean that a person has epilepsy. A seizure can happen because of a temporary problem, an underlying brain condition, an illness, metabolic changes or other factors.

This guide explains seizures in simple language, including their causes, symptoms, types, common triggers, first aid and when medical attention is necessary.

Important: A first-time seizure needs medical evaluation. If a seizure lasts more than five minutes, another seizure begins before the person has recovered, breathing is difficult, or the person is injured, emergency medical help is needed.

What is a seizure?

A seizure is a sudden burst or surge of abnormal electrical activity in the brain. Because the brain controls movement, awareness, sensation, behaviour and many automatic body functions, a seizure can temporarily affect any of these.

A seizure may involve:

• Loss of awareness or consciousness
• Staring blankly
• Uncontrolled jerking or shaking
• Sudden muscle stiffness
• Temporary confusion
• Unusual smells, tastes, sounds or visual experiences
• Changes in emotions
• Repetitive movements such as lip-smacking or picking at clothing
• Loss of bladder or bowel control

Not every seizure causes shaking or loss of consciousness. Some seizures are subtle enough that other people may not immediately realise that a seizure is happening.

What happens when someone has a seizure?

During a seizure, abnormal electrical activity temporarily disrupts normal brain function. What happens next depends largely on which part of the brain is involved and how widely the electrical activity spreads.

For example, a person may suddenly become unaware of their surroundings, stare into space, develop unusual sensations or begin making repetitive movements. In a generalized tonic-clonic seizure, the person may lose consciousness, fall, become stiff and then develop rhythmic jerking movements.

After the seizure, the person may be confused, tired, sleepy or sore. This recovery period is called the postictal phase. Not everyone experiences every stage of a seizure, and some seizures begin without any obvious warning.

What does a seizure look like?

There is no single appearance of a seizure.

A person having a generalized tonic-clonic seizure may:

• Suddenly lose consciousness
• Fall to the ground
• Become stiff
• Shake or jerk rhythmically
• Make an unusual sound
• Have abnormal breathing temporarily
• Become confused or extremely tired afterward

A focal seizure may look very different. The person could remain awake but experience an unusual smell, taste, visual sensation or feeling in the stomach. They may also have abnormal movements affecting one part of the body.

During a focal impaired-awareness seizure, a person may appear confused or dazed, fail to respond appropriately, stare blankly, smack their lips or repeatedly pick at their clothes.

What are the first signs of a seizure?

Some people experience warning symptoms shortly before a seizure. These may include:

• A strange smell or taste
• Tingling or numbness
• Changes in vision
• Hearing unusual sounds
• Sudden fear or another strong emotion
• Déjà vu
• Dizziness
• Nausea
• Sweating
• A strange sensation in the stomach

These symptoms can be part of an aura, which is actually a type of focal seizure and may occur before a seizure spreads to other parts of the brain.

However, many seizures occur suddenly, without an obvious warning.

What causes a seizure?

There are many possible causes. In some people, no immediate cause is identified.

Potential causes include:

• Epilepsy
• Stroke
• Head injury or traumatic brain injury
• Brain tumour
• Brain infection such as meningitis or encephalitis
• Lack of oxygen to the brain
• Very low or very high blood sugar
• Low sodium or other electrolyte abnormalities
• Certain genetic or developmental brain conditions
• Some degenerative brain diseases
• Certain medications or toxic substances
• Alcohol withdrawal
• High fever or severe illness
• Pregnancy-related conditions such as eclampsia

A seizure can also be provoked, meaning a temporary condition or circumstance contributes to it. An unprovoked seizure occurs without an immediate reversible trigger and may be associated with epilepsy.

What causes seizures in adults for the first time?

A first seizure in an adult should not simply be assumed to be epilepsy.

Doctors may investigate possibilities such as:

• Stroke
• Previous or recent head trauma
• Brain tumour or another structural brain problem
• Brain infection
• Abnormal blood glucose
• Electrolyte disturbances
• Alcohol or drug withdrawal
• Medication effects
• Lack of sleep
• Metabolic problems
• An underlying seizure disorder

The evaluation may include a neurological examination, blood tests and, depending on the circumstances, an EEG, CT scan or MRI.

A person who experiences a first seizure should receive prompt medical assessment.

What are the 7 types of seizures?

Seizures are classified in several ways, and modern classification is more detailed than simply listing seven types. Broadly, seizures are divided into focal and generalized seizures based on where they begin.

Seven commonly discussed seizure types are:

1. Focal onset aware seizure – awareness is preserved, although unusual sensations or movements may occur.
2. Focal impaired awareness seizure – awareness is affected and the person may appear confused or unresponsive.
3. Absence seizure – a brief lapse in awareness, often appearing as a blank stare.
4. Tonic seizure – muscles suddenly become stiff.
5. Clonic seizure – rhythmic jerking movements occur.
6. Myoclonic seizure – very brief, sudden muscle jerks occur.
7. Atonic seizure – there is a sudden loss of muscle tone, which can cause a person to fall.

Tonic-clonic seizures are another important generalized seizure type and involve stiffening followed by rhythmic jerking, usually with loss of consciousness. The terminology used to classify seizures has evolved, so medical professionals may describe seizures more specifically according to their onset and features.

What are silent seizures?

“Silent seizure” is not a precise medical classification. People sometimes use this phrase to describe seizures that are difficult to notice.

For example, an absence seizure may last only a few seconds and look like the person is simply staring into space. The person may briefly stop responding, blink repeatedly or make small movements without appearing obviously unwell.

Repeated episodes of unexplained staring, confusion or unusual behaviour should be discussed with a doctor, particularly if they occur regularly.

Can stress cause a seizure?

Stress can act as a seizure trigger for some people, particularly those who already have a seizure disorder. Stress may also indirectly contribute by disrupting sleep or daily routines.

However, experiencing stress does not mean that someone will necessarily have a seizure. Triggers vary significantly from person to person.

Keeping a seizure diary can help identify whether particular situations repeatedly occur before seizures.

Can anxiety cause seizures?

Anxiety and seizures are different conditions, although they can sometimes overlap.

Anxiety may contribute to circumstances that increase seizure risk, such as poor sleep or significant stress. Some people with epilepsy also experience anxiety because of concerns about having another seizure.

Importantly, not every episode that looks like a seizure is caused by abnormal electrical activity in the brain. Some events can have other causes, including functional or psychogenic nonepileptic seizures. Proper medical assessment is therefore important before assuming what an episode represents.

Can lack of sleep cause seizures?

Yes. Sleep deprivation can trigger seizures in some people. Poor sleep may make seizures more likely and, in people with epilepsy, can contribute to poorer seizure control.

Maintaining a regular sleep schedule is therefore an important part of seizure management.

If someone has recurrent seizures, it is useful to discuss sleep patterns with their healthcare professional rather than assuming that lack of sleep is the only cause.

What are 7 common triggers for seizures?

Triggers vary between individuals, but commonly reported triggers include:

1. Lack of sleep
2. Stress
3. Illness or fever
4. Flashing or flickering lights
5. Alcohol use or alcohol withdrawal
6. Missed antiseizure medication
7. Dehydration, prolonged periods without food or low blood sugar

Other possible triggers include hormonal changes, certain medications, recreational drugs and particular individual circumstances.

A trigger is not necessarily the underlying cause of epilepsy. It is something that may increase the likelihood of a seizure occurring.

How long do seizures last?

Most seizures are brief. Mayo Clinic states that many seizures last around 30 seconds to two minutes, although the duration varies depending on the type.

The most important time threshold to remember is five minutes.

A seizure lasting longer than five minutes is a medical emergency. Repeated seizures occurring without the person returning to their normal level of awareness also require emergency medical attention.

If you witness a seizure, start timing it as soon as possible.

What to do when you see someone having a seizure?

Knowing basic seizure first aid can help prevent injuries.

During the seizure

Stay calm and stay with the person.

Move nearby objects that could cause injury. If the person is falling, gently guide them to the floor if possible.

If they are lying down, turn them gently onto their side when practical, keeping the mouth directed downward to help maintain a clear airway.

Place something soft and flat under their head, remove glasses if they are wearing them and loosen tight clothing around the neck.

Most importantly, time the seizure.

What not to do

Do not:

• Hold the person down
• Try to stop their movements
• Put anything into their mouth
• Try to force their mouth open
• Give food or water while they are not fully alert
• Give mouth-to-mouth breaths during the seizure

Putting an object in someone’s mouth can cause injury to the teeth or jaw and can create additional danger.

When should you call emergency services?

Emergency medical help is particularly important when:

• The seizure lasts longer than five minutes
• Another seizure starts soon after the first
• The person has difficulty breathing
• The person does not wake up or regain awareness after the seizure
• They are seriously injured
• The seizure occurs in water
• It is the person’s first known seizure
• The person is pregnant
• The person has diabetes and loses consciousness

These circumstances warrant urgent medical assessment.

What is the difference between epilepsy and seizures?

A seizure is an event caused by abnormal electrical activity in the brain.

Epilepsy is a neurological disorder in which a person has an enduring tendency to have recurrent unprovoked seizures.

Therefore, having one seizure does not automatically mean that someone has epilepsy. Some seizures are caused by temporary or reversible circumstances.

A doctor needs to assess the person’s history, examination findings and, where appropriate, test results before determining whether epilepsy is present.

Is a seizure a serious problem?

A seizure can be serious, but its significance depends on its cause, type, duration and circumstances.

A brief seizure may resolve without causing lasting harm, but seizures can result in falls, burns, accidents and other injuries. Prolonged seizures are medical emergencies and can cause serious complications.

A first seizure also deserves medical attention because it may be the first sign of an underlying neurological, metabolic or structural problem.

How to avoid seizures?

Not every seizure can be prevented. However, people who have recurrent seizures can often reduce their risk by identifying and managing personal triggers.

Helpful measures may include:

• Taking prescribed antiseizure medication exactly as directed
• Avoiding missed doses
• Maintaining regular sleep
• Managing stress
• Staying adequately hydrated
• Eating regularly and maintaining balanced nutrition
• Limiting or avoiding alcohol if it is a trigger
• Avoiding recreational drugs
• Managing illnesses and fever appropriately
• Identifying personal seizure triggers
• Following the treatment plan recommended by a neurologist

Keeping a seizure diary can be particularly useful. Record the date and time of each seizure, sleep patterns, illness, stress, medication doses and anything unusual that happened beforehand.

What can stop seizures naturally?

There is no reliable home remedy that can safely stop an active seizure.

If someone is having a seizure, the priority is safety and timing, not trying to stop the movements with food, water, herbs or other home remedies.

Some people with diagnosed epilepsy may have an emergency seizure medication prescribed by their doctor or a personalised seizure action plan. These should be used exactly according to the instructions provided by the healthcare professional.

Lifestyle measures such as adequate sleep, stress management, good nutrition and avoiding known triggers may help reduce the likelihood of future seizures, but they should not replace medical treatment when treatment is required.

What to avoid after a seizure?

After a seizure, the person may remain confused or sleepy for some time.

Avoid giving food, drinks or medication by mouth until they are fully alert and able to swallow safely. Do not leave them alone immediately if they remain confused or unsteady.

Once they are alert, calmly explain what happened. If they have been injured, have difficulty breathing, do not recover normally or have another seizure, seek urgent medical attention.

The person should also avoid immediately returning to activities where impaired awareness could cause injury until they have recovered and received appropriate medical advice.

How is a seizure diagnosed?

Diagnosis begins with a detailed medical history. Information from someone who witnessed the episode can be extremely helpful because the person who had the seizure may not remember what happened.

Depending on the circumstances, a healthcare professional may recommend:

• Neurological examination
• Blood tests
• EEG
• CT scan
• MRI
• Other investigations based on the suspected cause

The aim is not only to establish whether the episode was a seizure, but also to understand its type and possible underlying cause.

How are seizures treated?

Treatment depends on why the seizure occurred and whether seizures are likely to recur.

Depending on the diagnosis, treatment may involve:

• Treating an underlying medical condition
• Antiseizure medication
• Surgery for selected patients
• Brain stimulation therapies in appropriate cases
• Specialised dietary therapy for some forms of difficult-to-control epilepsy

Treatment should always be individualised by a qualified healthcare professional.

Final thoughts

A seizure can look alarming, but understanding what is happening can help you respond calmly and safely. Remember the key points: protect the person from injury, do not restrain them, do not put anything in their mouth, time the seizure and seek emergency help if it lasts longer than five minutes or other warning circumstances occur.

If someone experiences a first seizure, unexplained loss of consciousness, repeated episodes of staring or unusual movements, medical evaluation is important. Finding the cause can help determine whether further seizures are likely and whether treatment is needed.

Frequently asked questions about seizures

What is a seizure?

A seizure is a temporary episode caused by abnormal electrical activity in the brain. It can affect awareness, movement, sensation, behaviour or consciousness.

What is the cause of a seizure?

Possible causes include epilepsy, stroke, head injury, brain infection, brain tumours, abnormal blood sugar or electrolytes, certain medications, substance withdrawal and other neurological or metabolic conditions. Sometimes no immediate cause is identified.

What are the first signs of a seizure?

Possible warning signs include unusual smells or tastes, visual changes, tingling, dizziness, nausea, déjà vu or sudden emotional changes. However, many seizures begin without warning.

Can stress cause a seizure?

Stress can trigger seizures in some people, particularly those with epilepsy. It may also indirectly increase risk by interfering with sleep.

Can anxiety cause seizures?

Anxiety itself is not the same as a seizure disorder. However, anxiety and stress can interact with seizure triggers, and anxiety is also relatively common among people living with seizures.

How long can a seizure last?

Many seizures last from about 30 seconds to two minutes, although duration varies. A seizure lasting more than five minutes is a medical emergency.

What should I do if someone is having a seizure?

Keep the person safe, remove nearby hazards, place them on their side when appropriate, protect their head, stay with them and time the seizure. Never restrain them or put anything in their mouth.

How can I prevent a seizure?

Complete prevention is not always possible. Taking prescribed medication correctly, getting adequate sleep, managing stress, avoiding known triggers and maintaining a healthy routine may help reduce seizure risk in people who are prone to seizures.

Can lack of sleep cause seizures?

Sleep deprivation can trigger seizures in some people and may worsen seizure control in people with epilepsy.

What are the seven common seizure types?

Commonly discussed types include focal onset aware, focal impaired awareness, absence, tonic, clonic, myoclonic and atonic seizures. Tonic-clonic seizures are another major generalized seizure type. Modern medical classification is more detailed than a simple list of seven types.

What are silent seizures?

“Silent seizure” is not a formal seizure category. The term is sometimes used for subtle seizures, such as absence seizures, where a person may briefly stare or become unaware without dramatic shaking.

What should you avoid after a seizure?

Do not give food, water or oral medication until the person is fully alert and able to swallow safely. Do not leave someone alone if they remain confused, have difficulty breathing or have not recovered normally.

What can stop seizures naturally?

There is no dependable natural remedy for stopping an active seizure. During a seizure, focus on first aid and seek emergency care when indicated. For long-term prevention, work with a healthcare professional to identify triggers and follow the prescribed treatment plan.

Is a seizure a serious problem?

It can be. Some seizures are brief and resolve on their own, but prolonged or repeated seizures can be dangerous. A first seizure should also be medically evaluated to look for a possible underlying cause.

To consult a Neurologist at Sparsh Diagnostic Centre, call our helpline number 9830117733.

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