Epilepsy Know How by Dr. N. R. Halder

1. Emergency tips for epilepsy
And
General Care for an Epileptic Individual

2. W h a t t o d o if s o m e o n e
g e t s a c o n v u l s iv e s e iz u r e :
Here are a few things you can do to help someone who is having a seizure of
any kind:
Many seizure types-such as generalized absence seizures or complex partial
seizures, which involve relatively brief episodes of unresponsiveness- don’t require
any specific first-aid measures.
Tonic Clonic Seizure
Convulsive seizure with loss of consciousness, muscle stiffening, falling, followed
by jerking movements.

6. C h e c k f o r In ju r y
•Make sure the victim's mental state has returned to normal. One
way to do this is to ask the person his or her name, the year, and
your location.
•Look for any injury to the mouth and head.

7. W h a t T o D o I f S o m e o n e H a s A No n -
C o n v u l s iv e S e iz u r e
(staring blankly, confused, not responding, movements
are purposeless)
1. Stay with the person. Let the seizure take its course. Speak
calmly and explain to others what is happening.
2. If the patient is standing or sitting when seizure begins, ease him
or her to the floor to prevent fall.
3. Move dangerous objects out of the way.
4. D O N O T r e s t r a i n t h e p e r s o n .
5. Gently guide the person away from danger or block access to
hazards.
6. After the seizure, talk reassuringly to the person.

8. C a llin g t h e A m b u la n c e
Most seizures due to epilepsy are not medical emergencies. They
end naturally after a minute or two. There is usually no need to call
for emergency help, unless, of course, the physician has advised it.
H o w e v e r , a n a m b u la n c e s h o u ld b e c a lle d
if :
• It's the first seizure a person has ever had
• Normal breathing does not start again after the shaking stops
• There are injuries or the seizure happened in water
• Other medical conditions, like diabetes, pregnancy or heart
disease are involved
• The seizure is prolonged (goes on for more than five minutes
without any sign of stopping)
• Another seizure starts soon after the first one
• You are concerned that something else may be wrong

9. DOCUMENTATION
Facts that should be recorded when a seizure occurs include:
1. Documentation and description of aura if reported by the patient
2. Circumstances in which the seizure activity occurred
3. Time of the onset of seizure activity
4. Muscle groups involved (and whether unilateral or bilateral)
5. Total length of seizure activity
6. Vital signs
7. Behavior after seizure
8. Neurologic status in postictal period (weakness or inactivity of a
body part, sleep, amnesia, confusion, or headache)
9. Documentation and assessment of any injury and
documentation that injury has been reported to the proper person

10. Safety and Seizures

11. Safety and Seizures
•Accidents can happen at any time to anyone. People take risks
every day, but sometimes risks people with epilepsy have to deal
with can be different from those faced by others.
•Safety precautions should be sensible and relevant to the
particular person involved, with a balance between risk and
restrictions.
•With an awareness of potential risks and ways in which these can
be lessened, activities can be much safer and most people with
epilepsy can live full and active lives.
•Enjoy life as much as you can and don't restrict activities to a point
where your interests and fun are excluded.

12. E v a lu a t in g P e r s o n a l R is k
•U n d e r s t a n d t h e t y p e
o f s e i z u r e : If you have drop
attacks or convulsions, you have an
increased risk of injury. Your risk is
probably lower if you have brief
staring episodes, or remain awake
and aware during seizures, or have
seizures only at night.
•F a l l d u r i n g a s e i z u r e ?
Loss of balance and falling
increases the risk of fractures, cuts
and bruises.
•Frequency of seizures – someone
who has many seizures a day is
more at risk.

13. R is k s
•Age – infants, children and older persons are more susceptible to
injuries and accidents
•Medications – people on multiple medications or very high doses
may suffer side effects such as drowsiness, double vision, poor
coordination
•Participation in high risk activities – If the activity takes place at
heights, near water, or near some other hazard, the risk of being
hurt during a seizure goes up also included are drinking alcohol,
taking drugs
•Any other physical or neurological problems

14. E v a lu a t in g P e r s o n a l R is k
Id e n t if y in g t h e
w a r n in g s ig n s
o r t r ig g e r s
If you do, changing
activities to avoid the
trigger as much as you
can reduces the risk of
related injury.
Keep an
E p ile p s y d ia r y ,
s o tha t
fre q u e n c y o f
s e iz u r e s c a n b e
und e rs to o d .

15. S a f e t y T ip s -- D a ily L iv in g
Some people with epilepsy will not need (or want) to make any
of these modifications to their lives.
• Make sure everyone in the family knows what to expect
when you have a seizure, knows correct seizure first aid
and knows when it is (or isn't) necessary to call for
emergency help.
• Know first aid for choking. Make sure your family and
friends do, too.
• Help young children in your family learn what to do by
having "seizure drills" that review first aid steps and how
to call for help.
• Avoid things which are known to increase the risk of a
seizure -- for example, forgetting to take medication; not
getting enough sleep; drinking a lot of alcohol.
•

16. Common accidents
Common accidents seen and ways to lessen the likelihood of accidents are listed
below. It is important to remember this list is not exhaustive and some
suggestions are not relevant to all people with epilepsy.
T o r e d u c e lik e lih o o d o f c u t s , b r u is e s a n d a b r a s io n s
•Reduce clutter, sharp or jutting edges and corners.
•Use a shower curtain rather than a glass screen. Also use a shower chair if
necessary.
•Reinforced glass doors are preferable or apply safety film to existing glass.
•Use non-breakable crockery and cordless electrical appliances with automatic
switch off.
•Minimise the use of knives by buying pre-sliced food when possible.
• Prefer microwave cooking instead of Gas flame

17. T o p r e v e n t d r o w n in g
•Never swim alone & avoid water sports
•Ensure that the water is not too hot.
•Wear an approved life jacket for water
activities, including boating and fishing.
•Showers pose less of a risk than a bath. If
you only have a bath, use a hand-held
shower attachment.
•Do not shower or bathe whilst alone in the
house if possible.
•Shower at a time when seizures are less
likely to happen.
•Preferably have outward opening doors,
sliding doors, half doors or doors that are
easily removable fitted to the bathrooms.
•Keep bathroom doors unlocked.
•Turn the taps off before getting into the
bath.

18. T o m in im is e s e r io u s
in ju r ie s
•Avoid high-risk activities like using a
ladder, rock climbing without a harness or
flying foxes.
•Wear helmets when riding a bicycle,
scooter, horse, or when roller-blading or
skateboarding.
•Choose a low bed and avoid sleeping on
a top bunk.
•Stand well back from the road or platform
edge when waiting for a bus or train.
•Bathroom floors may be less hazardous if
rubber-backed mats are used.
•Avoid living in accommodation with
stairs.

19. S u f f o c a t io n
•Try to sleep without a pillow or use a firm porous pillow.
•Choose a low wide bed that has a firm mattress with a tightly
fitted sheet.
•An alarm may help alert parents or carers to seizures at night
eg. baby monitor or intercom.

20. A v o id in g a c c id e n t a l o v e r d o s e
o f a n t ie p ile p t ic m e d ic a t io n
•All medications should be locked
away out of reach of children and not
be left in pockets and handbags.
•If a dose of medication is missed,
the next dose should be taken as
normal. Do not double the dose.
•Discuss possible reactions with your
doctor before taking any other
prescribed medications or over the
counter medications.
•Consult the doctor before altering
the prescribed medication regime.
• Mark tablet foils for dates & months,
using a marker pen (ease of dosing
schedule)

21. S e iz u r e s d u r in g s le e p
•Many families are concerned with the
safety of their loved ones while they
are asleep. This is of particular concern
to parents of young children who have
seizures and families of people living
alone.
•Family or parents should not stay
awake watching for seizures. Everyone
needs sleep, and this practice creates
tiredness and dysfunction in the whole
household.
•Place a baby monitor in the child's
bedroom so parents can hear any
abnormal noises

22. In K it c h e n s …
•Use a microwave oven rather than a stove.
•If using a stove, use back burners.
•Serve hot liquids or food onto plates at the stove
rather than carrying them to the table.
•Do not carry boiling water.
•If possible, cook when someone else is home.
•Use cups with lids.
•Sit down to do tasks when possible.
•Place sharp utensils downwards in the
dishwasher.
•Wear rubber gloves if washing glass or using
sharp utensils.
•Keep frequently used items within easy reach to
avoid having to climb up to high cupboards.
•Keep electrical appliances away from sinks.

23. W o r k p la c e S a f e t y
When working around machinery, check for safety guards.
Try to keep consistent work hours so you don't have to go a long time without
sleep.
If you are sensitive to flashing lights, try to limit your exposure. Look away if
you can. Use dark glasses. Some people think blue lenses work best.
Does stress make your seizures worse? Is your job a very stressful one? If so,
look at ways to reduce stress on the job.
Depending on your job and demands of the work site, consider wearing
protective clothing if you have frequent seizures.
Keep a small pillow tucked away in a drawer so a co-worker (who knows where
it is and what to do with it) can place it under your head if you have a
generalized tonic clonic (grand mal) seizure.
Keep a change of clothes at work in case your clothes get soiled during a
seizure.

24. T r a n s p o r t a t io n S a f e t y
Avoid driving a car unless you have a valid license and are not
having seizures.
Always wear a seat belt and insist your passengers do, too.
Stand well back from the road when waiting for a bus and from the
platform edge when taking the subway or train.
To avoid wandering during a seizure, take a friend along when you
travel.
If you have frequent seizures, the safety of taking a taxi cab
instead of public transportation may be worth the extra cost.

25. C h ild r e n ' s S a f e t y
A monitor in the child's bedroom may alert you to the sound of a typical
seizure.
Avoid top bunks. A lower bunk, a regular bed, a futon or even a
mattress on the floor is a safer place to sleep for a child with seizures.
Choking is a risk for any child, especially if the child has frequent
seizures and other disabilities. Children sometimes retain food in their
mouths and it's a good idea to check if this is a problem.
Put a list of first aid steps in a place where it's easy to find Write down
the phone number where you or a relative can be reached include the
doctor's number and the one for the emergency squad on the same
sheet.

26. M e d ic a l Id e n t if ic a t io n
There are a number of reasons why we
recommend wearing a medical ID bracelet if
seizures are not fully controlled. Some of these
include:
•Many members of public do not know the correct
first aid for a seizure.
•Incorrect first aid such as putting something in
someone's mouth or restraining them can cause
injury to either party.
•A large number of people would call an
ambulance if they witnessed a seizure.
•This is not always necessary and can prove an
inconvenience for the person with epilepsy, mainly
due to long waits in casualty and ambulance bills.
•Some seizures may present as if the person is
intoxicated or on drugs.

27. S a f e t y T ip s -- D a ily L iv in g
• Try using a pillbox to help you remember your medicines. Store
all medicines safely away from children.
• Wear a medical identification bracelet or card.
• If you have an aura (warning) before a seizure, lie down on your
side on a carpeted or other soft surface.
• Carry a small portable phone or beeper in case you have to call
for help and cannot get to a regular phone.
• If your seizures are very frequent and sudden, consider wearing a
helmet or other protective clothing, such as knee or elbow pads,
at least when you're at home alone.