Seizures
Seizures occur due to uncontrolled electrical activity in the brain, which may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms. The type of symptoms and seizures depend on where the abnormal electrical activity takes place in the brain, what its cause is, and such factors as the person’s age and general state of health. In half of patients who experience seizures, no cause can be found.
Absence Seizure
An absence seizure is known as a petit mal. The person stops suddenly and stares into the distance for up to 30 seconds. This type of seizure mainly occurs in children and is often mistaken for daydreaming or lack of concentration. No treatment is required except for reassurance.
Simple Partial Seizure
A partial (focal) seizure happens when unusual electrical activity affects a small area of the brain. This type of seizure does not affect awareness.
Seizures can be caused by any condition affecting the brain, for example:
Head injury.
Stroke.
Meningitis.
Brain tumors.
Lack of oxygen (hypoxia).
Some poisons or drugs.
Withdrawal from alcohol or drugs.
High temperature (febrile convulsion) in children under five years old.
Major Seizure
Tonic Phase – sudden spasm of muscles producing rigidity and the casualty falling down.
Clonic Phase – jerking movements of the head, arms and legs may occur.
Blue/purple skin colour and blue lips.
Loss of bladder and/or bowel control.
Noisy breathing, frothing of saliva from the mouth.
Unconsciousness.
Symptoms lasting from a few seconds to minutes.
May experience confusion, disorientation, headache and sleepiness when regaining consciousness.
Follow the DRSABCD emergency action plan.
Call 000 for an ambulance if required.
Protect the casualty from danger. Move items away from the casualty rather than attempting to move the casualty.
Loosen tight clothing.
Place something soft under the head.
Stay with the casualty until the seizure ends.
If the casualty vomits roll immediately onto their side to clear the airway.
Once the seizure has stopped place the casualty on their side.
Reassure the casualty.
Allow the casualty to sleep with supervision.
DO NOT restrain the casualty.
DO NOT place anything in the casualty’s mouth.
DO NOT force the casualty’s jaw open.
Call 000 for an ambulance if:
The seizure lasts more than five minutes.
If the person is pregnant.
If the person is a child or infant.
If the person has been injured.
Another seizure follows quickly.
It is the first known seizure.
The person has breathing difficulties after the jerking stops.
The person is a diabetic.
You are in any doubt.
The seizure has occurred in water.
The seizure lasts longer than normal for that person.
You arrive after the seizure has started.
Infantile Convulsion
Febrile convulsions (a fit or seizure caused by a fever) are caused by a sudden change in a child’s body temperature, usually associated with a fever (temperature above 38°C). A high temperature is a sign of infection somewhere in the body and is often caused by a virus or bacterial infection.
Febrile convulsions are not harmful to the child and do not cause brain damage. They are, however, quite upsetting for parents and caregivers to witness.
Loss of consciousness.
Muscles may stiffen or jerk.
Face goes red or blue.
The convulsion may last for several minutes.
When the movements stop, the child regains consciousness but remains sleepy or irritated.
During a febrile convulsion:
The most important thing is to stay calm – don’t panic.
Place the casualty on a soft surface, lying them on their back.
DO NOT restrain the casualty.
Call 000 for an ambulance if no improvement.
DO NOT put anything in their mouth, including your fingers – the child will not choke or swallow their tongue.
Try to watch exactly what happens, so that you can describe it later to medical personnel.
Time how long the convulsion lasts.
DO NOT put a child who is having a convulsion in the bath.
After the convulsion:
Once the convulsion ends position the casualty on their side.
Clear and open the airway and check that normal breathing has returned (watch for the rise and fall of the chest).
Call 000 for an ambulance
Remember: there is nothing you can do to make the convulsion stop.
Avoid giving the child anything to eat or drink until fully conscious.
Do not cool the child by artificial means such as fanning or putting in a cold bath, this can cause complications.
Allow their temperature to fall by natural means.
Obtain medical advice as soon as possible to diagnose the cause of the seizure/convulsion and to receive appropriate medical treatment.
