First Aid for Epilepsy: What to Do During a Seizure Episode

What Is Epilepsy, and Why Does First Aid Matter?

Epilepsy is a brain condition that causes sudden, repeated seizures. It is a chronic neurological disorder marked by recurring seizures. A seizure happens when a burst of abnormal electrical signals in the brain briefly disrupts how the brain works. This can affect how a person moves, feels, or acts – sometimes for just a few seconds, sometimes longer.

Seizures are common, affecting 1 in 10 people at some point during their lives. In India, the numbers are significant. According to WHO estimates, around 50 million people worldwide have epilepsy, and nearly 80% of them live in low- and middle-income countries – with an estimated 12 million in India. Among children specifically, a considerable majority of epilepsy cases begin in childhood, with estimates showing that more than 60% of people with epilepsy have their first seizure before the age of 18.

What does this mean for families in India? It means that if you are a parent, teacher, or caregiver of a child with epilepsy, the chances are real that you will one day witness a seizure. And being ready – knowing exactly what to do and what not to do – can make a big difference.

Early and correct first aid by family members, caregivers, or bystanders may reduce risks and improve health outcomes for the person affected. First aid for epilepsy does not mean stopping the seizure. It means keeping the child safe until the seizure ends on its own, and knowing when to call for help.

Understanding the Types of Seizures

You might think a seizure always looks the same – a person shaking and falling down. That’s actually not always the case. There are many different types of seizures. Some cause a person to act confused or stare into space, while others cause someone to lose awareness, fall, and shake.

Broadly, seizures fall into two main groups:

Focal Seizures (Partial Seizures)

These start in one specific part of the brain. Someone having a focal seizure may not be aware of their surroundings or what they are doing. They may have unusual movements and behaviour, such as plucking at their clothes, smacking their lips, swallowing repeatedly, or wandering around.

In India, 53% of children diagnosed with epilepsy in a rural survey had focal epilepsy.

Generalized Seizures (Tonic-Clonic)

These affect the whole brain. Someone having a tonic-clonic seizure goes stiff, loses consciousness, falls to the floor, and begins to jerk or convulse. Among Indian children with epilepsy, the most common seizure type was generalised tonic-clonic seizures, accounting for 69.6% of cases.

Warning Signs Before a Seizure

Some children show early signs before a seizure starts. These are called “auras” and can include: – Feelings of anxiety or a strange smell or taste – A sense of déjà vu – Nausea or “butterflies” in the stomach – Visual changes like flashing lights

During focal onset seizures, the person may experience feelings such as déjà vu, an unpleasant smell or taste, or sensations like ‘butterflies’ or nausea.

Not every child will have a warning. Most seizures happen suddenly and without warning, last a short time – seconds or minutes – and stop by themselves.

Step-by-Step First Aid During a Seizure

Here’s what you actually do when a seizure happens. These steps are practical and anyone can follow them – parents, teachers, relatives, or friends.

Step 1 – Stay Calm and Stay With the Child

This sounds simple, but it matters. When you stay calm, others around you do too. Your calmness helps the child feel safer when they come back to awareness. Knowing what to do when someone has a seizure can help you feel prepared and less likely to panic.

Step 2 – Keep Them Safe From Injury

Remove anything near them that can cause an injury. Push furniture away, move sharp objects, and clear the floor around them.

Loosen anything around the neck that could block breathing. If they wear glasses, gently remove them. Place something soft and flat under their head, like a jacket.

Step 3 – Turn Them Onto Their Side

Turn them gently onto one side with their mouth pointing to the ground. This will keep their airway clear. This is one of the most important steps because it prevents them from choking on saliva.

Step 4 – Time the Seizure

The moment the seizure starts, check the time. Time the seizure to track if it lasts more than 5 minutes. If it does, seek immediate medical attention.

Most seizures last just a few minutes. If it goes beyond 5 minutes, that changes things – more on this in the emergency section below.

Step 5 – Do Not Restrain Them

Don’t hold the person or try to stop their movement. Holding someone down during a seizure can cause fractures or dislocations. The body needs to move through the seizure naturally.

Step 6 – Do Not Put Anything in Their Mouth

This is one of the most common – and most dangerous – mistakes people make. Do not force the mouth open. A person cannot swallow their tongue during a seizure. Putting objects in the mouth can break teeth, cause choking, or injure both the child and the helper.

Step 7 – Stay Until the Seizure Ends

Stay until the seizure ends naturally. Be friendly and reassuring as consciousness returns.

Step 8 – After the Seizure, Reassure and Comfort

When the seizure is over, help them sit in a safe place to recover. Once they are alert, comfort them and explain what happened.

Some people recover quickly after a seizure, but often they will be very tired, want to sleep, and may not feel back to normal for several hours. This is completely normal. Sit with them, speak calmly, and don’t rush them.

Don’t offer water or food until they are fully alert – this is not necessary and could cause them to choke.

Quick Reference – Dos and Don’ts at a Glance

DO:

• Stay with the child through the whole seizure
• Move hard or sharp objects away
• Place a soft, flat item under their head
• Turn them gently onto one side
• Time the seizure from the start
• Loosen anything tight around the neck
• Reassure them when they wake up
• Check for a medical ID bracelet – it may give information about their condition, medicines, and emergency contacts

DON’T:

• Don’t put anything in their mouth
• Don’t hold them down or restrain them
• Don’t give food, water, or medicine until fully awake
• Don’t leave them alone
• Don’t panic – most seizures end on their own

When to Call for Emergency Help

Usually, when a person has a seizure, there is no need to call for an ambulance. But there are clear situations where you must call for help immediately.

Call your local emergency number or take the child to the nearest hospital if:

• The seizure lasts longer than 5 minutes. A seizure lasting longer than 5 minutes – or 2 or more seizures in 5 minutes without full recovery between them – is a medical emergency.
• Another seizure starts right away. Sometimes seizures do not stop, or one follows another without the person recovering in between. If this goes on for 5 minutes or more, it is called status epilepticus. Status epilepticus in a tonic-clonic seizure is a medical emergency and the person needs urgent medical help.
• The child has trouble breathing after the seizure ends.
• This is their first-ever seizure and you don’t know the cause.
• The child was injured during the seizure.
• The seizure happened in water – even a shallow bath or pool.

A useful way to remember this: for someone you don’t know, follow the basic first aid message – Calm, Cushion, Call.

First Aid by Seizure Type: What Changes?

Seizure first aid varies depending on the type of seizure the person is experiencing. The most common seizure types each have recommended first aid responses.

For Tonic-Clonic (Convulsive) Seizures:

Gently roll the person onto their side as soon as possible and tilt their chin upwards to assist with breathing and to protect their airway. Stay with them until the seizure ends naturally, and calmly talk to them until they regain consciousness.

For Focal (Partial Awareness) Seizures:

The person may seem confused, blank, or do strange repeated movements. Do not grab or restrain them. Gently guide them away from danger, speak calmly, and stay close. Reassure the person that they are safe and that you will stay with them while they recover.

For Absence Seizures:

These are brief – sometimes just a few seconds of staring blankly. The child may not know it happened. No physical first aid is needed. Just stay calm, note the time, and gently redirect the child when they come back to awareness.

Common Myths About Seizure First Aid (And the Truth)

There are some things people believe about seizures that are just not true – and some of these wrong beliefs can actually cause harm. Let’s be honest and clear them up.

Myth 1: “You need to put something in their mouth so they don’t swallow their tongue.” This is completely false and dangerous. A person cannot swallow their tongue. Putting objects in the mouth can cause serious injury.

Myth 2: “Epilepsy is caused by supernatural forces.” Epilepsy is a brain condition – a neurological disorder – caused by abnormal electrical activity in the brain. It has nothing to do with supernatural causes or evil spirits.

Myth 3: “All seizures involve shaking and falling.” While there are many different types of seizures, people who experience them may be confused, not aware of what is going on, or unconscious. Some seizures look like a brief blank stare or subtle twitching.

Myth 4: “Epilepsy is a lifelong condition with no hope of control.” This is not always true. With the right treatment, many people with epilepsy lead full lives. Some types of childhood epilepsy can even resolve over time. Many people with active epilepsy do not receive appropriate treatment, leading to a large treatment gap. The lack of knowledge of epilepsy drugs, poverty, cultural beliefs, stigma, and shortage of trained professionals contribute to this gap. This is exactly why awareness matters so much.

Myth 5: “People with epilepsy cannot go to school or live normally.” Children with epilepsy can and do go to school, play, and grow just like other children. They need safe support, not isolation.

The Treatment Gap in India: Why First Aid Education Matters More Here

You might wonder why this article focuses so strongly on first aid awareness for Indian families. Here’s the honest answer: the treatment gap in India is real.

There are 50 million people living with epilepsy worldwide, and most reside in developing countries. About 10 million people with epilepsy are in India, and many do not receive appropriate treatment.

In a study of rural children in India, the treatment gap was 45.45%, with significant deficits in knowledge. There are significant deficits in diagnosis and treatment of pediatric epilepsy among the rural population of India.

Epilepsy affects approximately 1% of the Indian population, with higher prevalence in rural settings (1.9%) compared to urban areas (0.6%).

This matters because when formal medical care is delayed or hard to access, caregivers become the first line of response. Getting first aid right – at home, at school, in the community – can protect a child’s safety until they reach a doctor.

Proper education and appropriate healthcare services can make a tremendous change in a country like India.

How to Track Seizures: Using a Seizure Diary

First aid handles the moment. But caring for a child with epilepsy also means managing the bigger picture – and that starts with keeping records.

A seizure diary is a simple log where you write down details about each seizure your child has. Over time, this record helps the doctor see patterns and adjust treatment.

What to record in the seizure diary: – Date and time of the seizure – How long it lasted – What the child was doing just before it started – What the seizure looked like (shaking, staring, falling, etc.) – Any possible triggers – missed medication, poor sleep, fever, flashing lights – How long it took the child to recover and get back to normal

Seizure action plans can help you organise your seizure information and have it available when and where you need it.

You can download a free seizure diary template from the Nayi Disha platform. Use it consistently and bring it to every doctor’s appointment.

How to Prepare Others Around Your Child

One of the most useful things you can do as a parent is prepare the people around your child.

At School

Share basic seizure first aid steps with your child’s class teacher, school nurse, and physical education teacher. Let them know: – What type of seizures your child has – How long they usually last – What to do – and what not to do – When to call you or seek emergency help

If you are a parent of a child with epilepsy, you can use a seizure action plan specific to schools. Give a copy to the school nurse so appropriate people will know what to do if your child has a seizure.

At Home

Make sure grandparents, older siblings, domestic helpers, and frequent visitors know the basics. A short, clear conversation can go a long way.

In the Community

If your child joins a sports team, dance class, or tuition group, let the coach or teacher know. You don’t need to share everything – just the essentials of what to do if a seizure happens.

Epilepsy, Stigma, and Supporting Your Child’s Confidence

People with epilepsy frequently face discrimination and stigma, as well as social and economic difficulties. In India especially, cultural beliefs around epilepsy can make families reluctant to talk openly about the condition.

But here’s the thing – silence makes it worse, not better. When the people around your child don’t know what epilepsy is or what to do, fear takes over. That fear leads to exclusion.

The more openly you talk about your child’s epilepsy – with teachers, relatives, and friends – the more supported your child will feel. And children who feel supported do better. They go to school with more confidence. They participate more. They worry less.

Pediatric epilepsy has received increased attention in recent years due to its significant impact on the health, development, and quality of life of affected children and their families.

Your child’s epilepsy is one part of who they are – not the whole story.

Frequently Asked Questions

Q: What is the most important thing to do when a child has a seizure? 

Stay calm, keep them safe, turn them gently on their side, and time the seizure. Don’t put anything in their mouth.

Q: How long does a seizure usually last? 

Most seizures last just a few minutes. If it lasts more than 5 minutes, treat it as a medical emergency.

Q: Should I call an ambulance every time my child has a seizure? 

Usually, when a person has a seizure, there is no need to call an ambulance. But call for help if the seizure lasts over 5 minutes, another follows immediately, the child is injured, has trouble breathing, or it’s their first-ever seizure.

Q: Can a person swallow their tongue during a seizure? 

No. This is a myth. Never put anything in someone’s mouth during a seizure – it can cause choking or injury.

Q: What is status epilepticus? 

Status epilepticus is when a seizure lasts a long time or when you have one seizure after another without recovering in between. It is a medical emergency.

Q: How do I track my child’s seizures? 

Use a seizure diary. Record the date, time, duration, what happened just before, and how long recovery took. Download a free template from Nayi Disha.

Q: What should I tell my child’s school about their epilepsy? 

Share the type of seizures, how long they usually last, what to do during one, and when to call for emergency help. Give the school nurse a written seizure action plan.

Q: Can children with epilepsy live normal lives? 

Yes. With the right treatment and support, most children with epilepsy attend school, play, and grow just like other children.

Need More Help?

If you have questions about epilepsy, autism, Down syndrome, ADHD, or other developmental conditions, the Nayi Disha team is here for you.

Call or WhatsApp our free helpline: 844-844-8996

Our counsellors speak English, Hindi, Malayalam, Gujarati, Marathi, Telugu, and Bengali.

Additionally, you can also check out these videos on learning and understanding more about epilepsy. 

Acknowledgements

We thank our volunteers Ms. Sailaja Tadimeti and Mr. Krishnaji Devalkar for translating this content into Telugu, and Ms. Prerana Chouk and Ms. Hemanta Nijhawan for the Hindi translation. Their support helps make this information accessible to families across India.

Disclaimer: This article is for general information only. Always consult a qualified healthcare professional for personalised medical advice, diagnosis, and treatment related to epilepsy or seizures.