CDBC/BCAAN Education Bite, Originally emailed June 6, 2025
About seizures
Focal seizures occur when there is seizure activity in a specific part of the brain. Focal seizures can look many different ways including chewing movements, or random-seeming behaviour such as picking at clothes, walking aimlessly, or mumbling. The person may feel sensations, emotions, or involuntary jerking of certain parts of the body. In some focal seizures, the person may be unaware (focal dyscognitive seizures, previously called complex partial seizures).
Generalized seizures occur due to widespread seizure activity throughout both hemispheres. Absence seizures are a type of generalized seizure that involve a period of unconsciousness with a blank stare and sometimes chewing movements, blinking, or tugging at clothing. During an absence seizure, a person will not remember what happened, and will typically resume right after where they left off. Tonic-clonic seizures (previously called “grand mal”) involve stiffening which causes a fall to the floor and rhythmic jerking/twitching. After this type of seizure, there is typically fatigue and confusion. Myoclonic seizures involve abrupt muscle jerks and consciousness is not impaired. There are also atonic (drop) seizures, tonic seizures, and clonic seizures.
How to support someone during a seizure
Watch this 4-minute video on seizure first aid from Epilepsy Toronto.
If you have a patient with epilepsy, start by asking about what to look out for (what do their seizures look like, how long they last) and what kind of support you can provide during and after a seizure. Ask what kind of recovery time they need following a seizure. With some seizures, a person might typically feel “back to themselves” right away and ready to continue with what they were doing. For others, they will need a rest and time to recover.
During a seizure, remain calm and stay with the person. You may need to call for help unless the seizure plan does not require it. For example, for a person with absence seizures, they will pass quickly and the person should return to baseline.
During a seizure, ensure the person is safe by moving away objects that could harm them. Do not try to stop their activity or restrain them. Do not put anything in their mouth. For a generalized tonic-clonic seizure, help the person to the floor. Place something soft under their head to help prevent injury. After the seizure is over, turn them on their side in the recovery position in case they vomit (this prevents choking). Be calm and reassuring “You just had a seizure, you are OK.”
Time the seizure from the onset. If this is the person’s first seizure, or if the seizure is greater than 5 minutes, or if multiple seizures occur without coming back to baseline that lasts more than 5 minutes, they will likely need immediate medical assistance. Parents may have and administer special medication to stop the seizure.
Ensure you know how to activate the emergency protocol for your setting. At BC Children’s Hospital, Code Blue can be called only in coverage areas (ACB, BCCH, BCWH, HM, SHY, TACC). A code blue is for a medical emergency, for example, if a seizure does not stop after 5 minutes. If available, press the “Code Blue – Pediatric” button, or call the emergency line at x7111▸ State “Code Blue, [Pediatric/Adult], and [exact location – department/area, building, floor, room number]”
If the emergency occurs outside these areas including another building, or the parking lot/sidewalk, call 911 and also call campus security at 899. Tell security the location and that you have called 911.