What Happens During a Seizure
A seizure is a sudden, temporary burst of abnormal electrical activity in the brain. The way it looks depends on which part of the brain is involved. The type most people picture is a tonic-clonic (grand mal) seizure: the person may cry out, lose consciousness, stiffen, and then jerk rhythmically. Their breathing may look laboured, their lips may turn slightly blue, and they may bite their tongue or lose bladder control. It looks frightening, but the person is not in pain and is not aware of what is happening.
Other seizures are far quieter. In a focal seizure the person may stare blankly, make repetitive movements such as lip-smacking or fumbling, or seem confused and unresponsive for a minute or two without ever falling. These are just as much seizures as the dramatic kind, and the person still needs gentle protection and reassurance.
The single most important fact for a bystander is this: almost all seizures stop by themselves within one to three minutes. You cannot stop the seizure and you do not need to. Your entire job is to keep the person safe from injury while their brain settles, and to know the few situations that need an ambulance.
It helps to understand why a seizure looks the way it does. During a tonic-clonic seizure the muscles tighten and relax in rapid cycles, which is why the body jerks; the person is unconscious throughout and feels no pain, even though the sight is distressing to watch. Frothing at the mouth, a brief blue tinge to the lips, and loss of bladder or bowel control are all common and do not mean the person is dying — they are ordinary features of the seizure and settle as it passes. Knowing this in advance is what allows a bystander to stay calm, and calm is exactly what the person needs.
Step-by-Step First Aid
If someone near you has a convulsive seizure, follow these simple steps calmly:
- Stay calm and stay with them. Note the time the seizure starts — this matters more than almost anything else.
- Clear the area. Move away furniture, hot objects, sharp edges or anything hard they could strike.
- Protect the head. Place something soft — a folded jacket, a cushion, or your hands — under or around the head to stop it banging on the floor.
- Loosen anything tight around the neck, and remove glasses.
- Do not restrain them. Let the movements happen; holding a person down causes injuries to both of you.
- Wait for the jerking to stop, then gently turn them onto their side (the recovery position) to keep the airway clear.
- Stay until they are fully alert, reassure them quietly, and tell them what happened — they will be confused and may not remember.
That is genuinely all that most seizures require. Calm, protection, timing, and the recovery position afterwards.
What Absolutely NOT to Do (Common Myths Debunked)
Some of the most widespread "first aid" advice is not only wrong but actively harmful. Please unlearn all of the following.
Never put anything in the mouth
The old belief that a person can "swallow their tongue" during a seizure is a myth — it is anatomically impossible. Forcing a spoon, a finger, cloth or any object into the mouth breaks teeth, lacerates the mouth, obstructs breathing, and can result in a badly bitten finger. Never put anything in the mouth of someone having a seizure.
Never hold the person down
Trying to stop the jerking by restraining the limbs does not shorten the seizure and can dislocate joints or tear muscles. Let the movements run their course and simply clear the space around them.
Never give water, food or medicine
During a seizure the person cannot swallow safely; water or tablets can go into the lungs and cause a dangerous chest infection or choking. Give nothing by mouth until the person is fully awake and alert afterwards.
Other harmful myths
Do not make them smell onions, shoes or chillies — these do nothing and waste time. Do not throw water on them or slap them to "wake" them. Do not crowd around; give them air and privacy.
When to Call Emergency
Most seizures do not need an ambulance. But call for emergency help immediately if any of the following applies:
- The seizure lasts longer than 5 minutes, or you are unsure how long it has lasted.
- A second seizure follows soon after the first without the person recovering in between.
- The person does not regain consciousness or normal breathing after the jerking stops.
- It is a first-ever seizure in someone with no known epilepsy.
- The seizure happens to a person who is pregnant, diabetic, or has a high fever.
- The person is injured, has hit their head hard, or the seizure happened in water.
A seizure lasting more than five minutes is called status epilepticus and is a medical emergency that needs urgent treatment to stop it. In and around Mohali, call Gini's 24/7 emergency line on +91 82888 43800 or go straight to the nearest emergency department. When in doubt, it is always safer to call.
If you already know the person has epilepsy and their seizures usually stop within a couple of minutes and follow their normal pattern, a single brief seizure with full recovery afterwards does not automatically need an ambulance — this is often just part of living with the condition. What changes that is any of the warning signs above, or a seizure that simply does not look like their usual one. Trust your instinct: a seizure that feels different, goes on too long, or leaves the person not waking up is a reason to seek help without hesitation.
The Recovery Position — How to Do It
Once the convulsive movements have stopped, turning the person onto their side keeps the airway open and lets saliva or vomit drain out rather than block the throat. It is simple to do.
Kneel beside the person. Take the arm nearest to you and place it out at a right angle, palm up. Bring their far arm across their chest and rest the back of their hand against the cheek nearest you. Bend their far knee up, then gently roll them towards you by pulling on that bent knee, so they come to rest on their side. Tilt the head slightly back to keep the airway clear, and adjust the top leg so the hip and knee are bent at right angles for stability.
Stay with them and keep monitoring their breathing until they are fully alert. If at any point breathing looks abnormal or stops, or if they do not begin to wake, call emergency help without delay.
After the Seizure — What to Expect
The period straight after a seizure is called the post-ictal phase, and it can last anywhere from a few minutes to an hour or more. The person often wakes confused, drowsy, tearful or agitated, with a headache and aching muscles. Many have no memory of the seizure at all and may not even realise what has happened. This is completely normal and not a cause for fresh alarm on its own.
Reassure them calmly and repeatedly, tell them where they are and that they have had a seizure, and give them space and quiet. Do not offer food or drink until they are properly alert and can swallow safely. If they have bitten their tongue, wet themselves, or been injured, deal with it gently and without fuss — embarrassment is common and kindness matters. Let them rest afterwards.
It helps enormously to note down what you saw: the time it started and stopped, what the movements looked like, whether they lost consciousness, and how they were afterwards. This description is invaluable to a neurologist such as Dr. Iqbal Singh in confirming the diagnosis and choosing treatment. If this was a first seizure, or if seizures are becoming more frequent or changing in pattern, arrange a review through our epilepsy service.