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First aid and status epilepticus

In this section:

How someone can help you if you have a tonic-clonic seizure

If you have seizures that cause you to lose consciousness, you might like to talk to people about what to do to help you recover after a seizure. By being aware of the first aid for tonic-clonic seizures, you can reduce your risk of status epilepticus and SUDEP.

First aid for tonic-clonic seizures

The person goes stiff, loses consciousness and then falls to the floor. This is followed by jerking movements. After a minute or two the jerking movements should stop and consciousness should slowly return.

Do...

  • Protect the person from injury - (remove harmful objects from nearby)
  • Cushion their head
  • Look for an epilepsy identity card or identity jewellery
  • Aid breathing by gently placing the person in the recovery position when the seizure has finished (see picture)
  • Stay with them until recovery is complete
  • Be calmly reassuring

Don't…

  • Restrain the person’s movements
  • Put anything in their mouth
  • Try to move them, unless they are in danger
  • Give them anything to eat or drink until they are fully recovered
  • Attempt to bring them round

Call 999 for an ambulance if...

  • You know it is the person’s first seizure or
  • The seizure continues for more than five minutes or
  • One tonic-clonic seizure follows another without the person regaining consciousness between seizures or
  • The person is injured during the seizure or
  • You believe the person needs urgent medical attention

Remember ACTION for tonic-clonic seizures:

AAssess
Assess the situation – are they in danger of injuring themselves? Remove any nearby objects that could cause injury
CCushion
Cushion their head (with a jumper, for example) to protect them from head injury
TTime
Check the time – if the seizure lasts longer than five minutes you should call an ambulance
IIdentity
Look for a medical bracelet or ID card – it may give you information about the person’s seizures and what to do
OOver
Once the seizure is over, put them on their side (in the recovery position). Stay with them and reassure them as they come round
NNever
Never restrain the person, put something in their mouth or try to give them food or drink

The recovery position

The recovery position

If you would like to discuss anything to do with epilepsy-related death, you could speak to an adviser on the Epilepsy Action Helpline, 0808 800 5050 (UK only). You could also contact your family doctor, epilepsy specialist, or epilepsy nurse.

Status epilepticus

Many people have seizures that last for less than 5 minutes and stop without any treatment. But some people have seizures that last too long. These are known as status epilepticus and need treating urgently. This is to try and stop them before they cause long-term damage. The sooner the seizure is treated the easier it will be to get it to stop.
By the time a seizure is lasting for 30 minutes or more, it is much more difficult to stop. If a tonic-clonic or cluster of tonic-clonic seizures last longer than 30 minutes, this can cause damage to the brain, or even death.

Some research suggest that around 16 out of every 100 epilepsy-related deaths are caused by status epilepticus. A study from Northern Ireland suggests that between about 8 and 39 people out of every 100 who have status epilepticus die. The highest risk is for children and people over the age of 60.

Reducing the risk of death from status epilepticus

Around 1 in 20 of all people with epilepsy will have an episode of status epilepticus at some point. These are some possible ways of reducing your risk of status-epilepticus:

If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.

Code: 
F006.06
Event Date: 
Thursday 31 March 2016 - 15:22

Epilepsy Action would like to thank Consultant Neurologist Dr John Paul Leach of Southern General Hospital Glasgow for his contributions to this information. He has declared no conflict of interest.

This information has been produced under the terms of The Information Standard.

  • Updated February 2019
    To be reviewed April 2022

Comments: read the 1 comments or add yours

Comments

Can you please raise awareness that focal seizures can also result in status epilepticus. My son has recently spent a week in hospital with what began as tonic-clonic status but ended with over 24 hours of focal status which even the doctors seemed unsure how to treat without seeking advice from a specialist epilepsy unit. Focal status epilepticus is rarely ever mentioned. Whilst it may not be as life threatening I'm sure it still carries risks and people should be aware. Thank you

Submitted by Joyce Johnston on

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