First Seizure

First seizure: Advice, guidance, and driving

This leaflet contains information for those who have had a suspected seizure. It is also useful for family, friends or those who care for a person who has had a seizure for the first time.  

It is important to remember that having a seizure for the first time does not automatically mean the individual has epilepsy. Epilepsy is usually diagnosed after two or more seizures.

There are other conditions that can cause seizures which may look like epileptic seizures, for example some faints can do so. There is no single test that can diagnose epilepsy.

There is a risk of further seizures, and the following information is aimed to provide advice on how to keep yourself and others safe.

If you do have another seizure

If you experience another seizure, it is advised that you should get in contact with your GP or attend the Emergency Department (ED) if needed.

• Your GP should be contacted if a seizure does not require an ambulance
• You should call an ambulance if a convulsive seizure lasts 5 minutes or more or if you go straight into another seizure without recovery in between
• You should also call an ambulance if you are injured or concerned

Driving

If you hold a driving license you have a legal responsibility to stop driving and inform the Driver and Vehicle Licensing Agency (DVLA). You may be able to resume driving in the future depending on the occurrence of future seizures.

The DVLA makes the decision regarding driving and will inform you when you are permitted to resume driving.

This is usually after a period of 6-12 months, and you must not resume driving until advised by the DVLA to do so.

More information on DVLA can be found at:https://www.gov.uk/government/organisations/driver-and-vehicle-licensing-agency

Safety and lifestyle measures

Safety measures

Risks from seizures vary between different people. Although you do not have to stop all your normal activities, some precautions to minimise the risk of injury if you have a further seizure include:

• Using a shower instead of a bath, and ensuring someone else is in the house to check you are safe
• Taking extra care when cooking, using a microwave rather than a cooker where you can
• Avoiding swimming unaccompanied, and swimming only in the presence of a lifeguard would be encouraged
• Avoid climbing ladders

Lifestyle measures

There may be certain lifestyle measures that lessen the chance of you having another seizure which include:

• Ensure regular meals and good hydration
• Avoid sleep deprivation or an erratic or irregular sleeping pattern
• Avoid or limit the amount of alcohol
• Avoid recreational drugs
• Avoid excessive stress and tiredness

Employment and working

Depending on the nature of your work, some precautions, or alterations to work pattern may need to be put in place. This includes working with dangerous machinery, driving any vehicle or flying, and working in the fire service, armed forces, and police.

There are other job roles that may put you and others at risk of harm. It is encouraged that you speak to your employer about a risk assessment.

First aid

Seizure first aid for family members, friends, and/ or caregivers

Knowing what to do in the event of a seizure can make you feel more prepared and cause less panic when you see one. It is important to stay with the person who is having the seizure until it is over, and the person is fully recovered.

First aid includes:

• Keep calm and prevent others from crowding
• Start timing the seizure and remove any potential hazards in the surrounding area if safe to do so
• Be calmly reassuring and only intervene if you need to guide the person away from potential danger (e.g., roads and open water)
• Let the person come round on their own trying not to act in a way that could frighten them e.g., making abrupt movements or shouting at them
• If they have fallen, cushion the head with something soft and loosen clothing around the neck
• Once the seizure has stopped place the person in a recovery position (if they have fallen or are near to the ground). Stay with the person and reassure them as they come round.

 EMERGENCY- Call 999 if:

• A convulsive seizure lasts for more than 5 minutes, or the person goes straight into another convulsive seizure without recovering in between
• The person has injured themselves during a seizure
• You are concerned

It is important to remember some individuals may have seizures where they display a change in their behaviour. They may also have unusual movements. When this happens, it is advised to stay calm and stay with the person.

Sometimes they may wander round, and you should walk with them to ensure they don’t injure themselves. By staying calm, you may help the episode pass more quickly and avoid causing further confusion for the individual.

If possible and safe a video of the seizure is useful as this may be able to assist the neurologist in their diagnosis.

Sudden Unexpected Death in Epilepsy (SUDEP)

Sudden Unexpected Death in Epilepsy (SUDEP) is when a person with epilepsy suddenly dies and no other cause for the death is found. SUDEP may happen during or after a seizure. SUDEP is rare and its exact cause is still unknown. Approximately 1 in 1000 adults with epilepsy lose their lives to SUDEP every year.

Research shows that certain factors put you at an increased risk of SUDEP which include:

• Those with convulsive seizures (also described as tonic-clonic seizures) are more at risk of SUDEP
• Sleep seizures (research shows SUDEP often happens overnight)
• Not taking epilepsy medicines regularly (this can be a trigger for seizures)
• Alcohol and drug dependency
• Living alone

There are ways you may be able to reduce the risk of SUDEP and more information can be found at: https://sudep.org/

For further information and advice for people with neurological conditions visit thebraincharity.org or call 0151 298 2999