What are the emergency measures for an epileptic seizure?

Written by Wang Xiang Li
Emergency Medicine
Updated on January 11, 2025
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Epilepsy is a chronic disease characterized by transient brain dysfunction caused by sudden abnormal discharge of brain neurons. When a patient has an acute attack, several emergency measures should be taken to prevent injury:

1. During an epileptic seizure, the patient should lie flat, with the head turned to one side or on their side, to keep the airway clear and prevent the inhalation of vomit or secretions into the respiratory tract.

2. Be aware of the surrounding environment to prevent the patient from bumping into tables and chairs, causing secondary injuries. Closely observe the patient's consciousness, breathing, and pulse.

3. Loosen the patient's collar and belt to reduce resistance in the respiratory tract, and place a gauze-wrapped tongue depressor between the teeth to prevent tongue biting and vocalization.

4. Observe whether the patient shows symptoms of increased intracranial pressure and follow medical advice for medication when necessary. Additionally, for persistent epileptic seizures, call emergency services promptly for treatment.

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What are the early symptoms of epilepsy in children?

Epilepsy is a particularly common chronic disease in life. If the brain is underdeveloped and there are neurological disorders, it can cause epilepsy. What are the early symptoms of childhood epilepsy? The manifestations of a child's epileptic seizure are diverse, but all have the characteristics of sudden onset, sudden cessation, and periodic attacks. Common types in children include major seizures, absence minor seizures, and benign childhood epilepsy. During a major seizure, the child suddenly loses consciousness, breathing stops, the complexion turns cyanotic, the pupils dilate, the limbs stiffen, and the hands clench into fists, then switching to paroxysmal convulsions, foaming at the mouth, with the attack generally lasting 1-5 minutes. Children with absence seizures appear to suddenly lose consciousness, stop their activities, and stare upward or roll their eyes, but they do not fall down or convulse, lasting 1-10 seconds, with consciousness quickly recovering after the attack. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, and tongue, possibly accompanied by abnormal sensations in those areas, inability to speak, and drooling, typically with clear consciousness, and more frequently occurring at night.

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Care for children during epileptic seizures

During an epileptic seizure, it is crucial to control the seizure promptly by using sedative and anticonvulsant medications. While administering these drugs, it is important to closely monitor for consistent breathing. Additionally, during a seizure, it is necessary to ensure that the airway remains clear, provide oxygen, and, if required, use mechanical ventilation to maintain airway patency. Prevent biting injuries to the tongue and position the head to one side so that secretions can flow out of the corner of the mouth, preventing reflux of stomach contents and risk of choking. Protect brain function and vital organs, and prevent cerebral edema. After the seizure has stopped, long-term administration of antiepileptic drugs should be continued to prevent recurrence.

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Written by Liu Shi Xiang
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What are the initial symptoms of sleep-related epilepsy?

The initial symptoms of sleep-related epilepsy mainly include sudden opening of the eyes and panic symptoms at the onset of sleep. A few patients may exhibit aggressive behavior towards others, and some may experience movement disorders and abnormal muscle tone. For these patients, it is necessary to promptly receive examinations and treatment in neurology. Diagnostic methods mainly include video EEG, ambulatory EEG, cranial CT, and MRI, among others. Once diagnosed, timely intervention should be provided. For some patients, if it is the first seizure and not frequent, interventions through lifestyle and sleep adjustments can be implemented without immediately resorting to medication. If these adjustments are ineffective or if the patient frequently experiences seizures, appropriate medications should be administered in a timely manner, including drugs such as sodium valproate, carbamazepine, oxcarbazepine, and levetiracetam, among others. (Medication should be taken under the guidance of a doctor)

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What is an effective treatment for epilepsy?

To effectively treat epilepsy, it is crucial to adhere to the principles of medication use and cessation. First, epilepsy medication should generally be administered for one to two years without seizures before gradually reducing the dose. If seizures reoccur after dose reduction, or if there is significant worsening on electroencephalography (EEG), the dosage should be restored. If switching medications, take both medications concurrently for about a week, then gradually reduce the original medication to cessation while increasing the new medication to an effective dose. These are the principles of medication exchange and use. Then, consider the principles for attempting medication cessation. Generally, medication should not be ceased any earlier than one year and abrupt cessation should be avoided to prevent epilepticus status. If there is clear organic brain disease, persistent positive neurological signs, or continuous mental disorders with abnormal EEG readings, lifelong medication may be necessary. Some suggest that individuals older than 30 should be cautious about stopping medication. Since the recurrence rate upon cessation can exceed 50%, lifelong medication may be necessary.

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What are the prodromal symptoms of epilepsy?

The prodromal symptoms of epilepsy are diverse, generally involving movement, sensation, and mood. Some patients may experience transient numbness or weakness on one side of their body prior to a seizure, while others may have hallucinations and atypical mental or behavioral changes. However, these symptoms are not necessarily indicative of an impending seizure. When such symptoms occur, it is crucial to consider the possibility of an epilepsy attack, and patients should promptly visit the neurology department of a hospital for a thorough examination, including an electroencephalogram (EEG). If the EEG shows significant abnormalities such as spikes, sharp waves, slow waves, spike-and-wave complexes, or sharp-and-slow wave complexes, it suggests the potential for an epileptic seizure. In such cases, preventive medication should be administered promptly, such as carbamazepine or sodium valproate.