Recognizing Seizures: Key Signs, First Aid, and When to Call 911

Seizure manifestations vary by type. Recognition ensures timely, appropriate response.

Common Seizure Signs

Type	Key Features
Focal Aware (Simple Partial)	Aura only: déjà vu, epigastric rise, sensory (tingling, visual, olfactory), emotional (fear), motor (twitching) — consciousness intact
Focal Impaired Awareness (Complex Partial)	Staring, automatisms (lip-smacking, fumbling, wandering), unresponsive, postictal confusion
Focal to Bilateral Tonic-Clonic	Starts focal → spreads → tonic (stiffening) → clonic (jerking) — formerly "secondarily generalized"
Generalized Tonic-Clonic (GTCS)	Sudden LOC, tonic extension → clonic jerking, apnea, tongue biting, incontinence, postictal exhaustion/confusion
Absence	Brief (5–10 sec) stare, eyelid flutter, abrupt onset/offset, no postictal — child "spaces out"
Myoclonic	Brief shock-like jerks (arms/legs), often morning
Atonic (Drop)	Sudden tone loss → fall (head injury risk)
Tonic	Sustained stiffening (often sleep)

First Aid: "STAY, SAFE, SIDE"

• STAY with person; time seizure.
• SAFE: Clear area; cushion head; remove glasses; loosen tight neckwear.
• SIDE: Roll onto side (recovery position) — protects airway.
• DO NOT: Restrain, put anything in mouth, give water/food until fully alert.

Call 911 If

• Seizure >5 minutes
• Repeated seizures without recovery (status epilepticus)
• First known seizure
• Injury, difficulty breathing, cyanosis persists
• Occurs in water
• Pregnant, diabetic, known heart disease
• Person requests ambulance

After: Reassure, document details (onset, duration, features), ensure follow-up with neurologist.