Epilepsy - Medications

Treatment

What To Do When Someone Has a Seizure

You cannot stop a seizure, but you can help the patient prevent serious injury.

Remain calm, and do not panic, then take the following actions:

• Wipe away any excess saliva to prevent obstruction of the airway. Do not put anything in the patient's mouth. It is not true that people having seizures will swallow their tongues.
• Turn the patient gently on the side. Do not try to hold the patient down to prevent shaking.
• Rest the patient's head on something flat and soft to protect it from banging on the floor and to support the neck.
• Move sharp objects out of the way to prevent injury.

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Do not leave the patient alone. Someone nearby should call 911. Patients should be taken to an emergency room when:

• A first-time seizure occurs
• Any seizure lasts beyond 2 - 3 minutes
• The patient has been injured
• The patient is pregnant
• The patient has diabetes
• Parents, caregivers, or bystanders are at all uncertain

Not all patients with chronic epilepsy need to go to the hospital after a seizure. Hospitalization may not be necessary for patients whose seizures are not severe or repetitive, and who have no risk factors for complications. All patients or caregivers, however, should contact their doctors after a seizure occurs.

Starting Drug Treatment

Treatment with anti-epileptic drugs (AEDs) is usually initiated or strongly considered for the following patients:

• Children and adults who have had two or three seizures. (If there was either a long period of time between seizures or the seizure was provoked by an injury or other specific causes, the doctor may wait before starting AEDs. In children, risk for recurrence after a single unprovoked seizure is rare. The risk even after a second seizure is low, even when the seizure is prolonged.)
• Children and adults after a single seizure if tests (EEG or MRI) reveal any brain injury, or if specific neurologic, developmental, or epilepsy syndromes put a person at special risk for recurrence, for instance, in cases of myoclonic epilepsy.