AI Summary Overview
What are Seizures?
A seizure occurs when abnormal electrical activity temporarily disrupts normal brain function. Symptoms depend on the area of the brain involved and may include staring, unusual sensations, repetitive movements, muscle stiffening, jerking or loss of consciousness.
Not every seizure causes convulsions. Some people remain conscious throughout the episode. A single seizure does not automatically mean that a person has epilepsy, which is generally associated with a tendency to have recurrent unprovoked seizures.
What are the Types of Seizures?
Seizures are classified according to how abnormal electrical activity involves the brain. The main types of seizures include:
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Focal Seizures Focal seizures involve abnormal electrical activity within networks in one side of the brain. Consciousness may remain preserved or become impaired during the episode. A focal seizure can sometimes spread to both sides of the brain and develop into a focal-to-bilateral tonic-clonic seizure.
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Generalised Seizures Generalised seizures involve brain networks on both sides. Examples include tonic-clonic, absence, myoclonic, tonic and atonic seizures.
What are the Stages of Seizures?
Although seizures do not follow a fixed pattern in everyone, some episodes may occur in distinct phases. These phases can include changes before the seizure, the seizure itself and the recovery period afterwards.
The phases of seizures are described in the table below:
| Phase | Typical Features |
| Prodromal Phase | Some people notice mood changes, irritability, difficulty concentrating, headache or a general sense that a seizure may occur hours or occasionally longer before the episode. |
| Aura/ Initial Seizure Symptoms | Some focal seizures begin with unusual smells or tastes, déjà vu, fear, visual changes, tingling, nausea or other unusual sensations. An aura is itself part of the seizure rather than a separate condition. |
| Ictal Phase | The actual seizure occurs. Symptoms may include staring, altered consciousness, repetitive movements, muscle stiffening, jerking or sensory changes depending on the seizure type. |
| Postictal Phase | During recovery, a person may experience confusion, tiredness, headache, muscle soreness, difficulty speaking, temporary memory problems or sleepiness. |
Some seizures begin and end suddenly without a recognisable warning or prolonged recovery period.
What are the Symptoms of Seizures?
Seizure symptoms vary widely according to the seizure type and areas of the brain involved. A person may experience only subtle changes in sensation or awareness during a seizure, while another may develop prominent muscle stiffening and jerking.
Early warning signs and severe stage symptoms of seizures are listed in the table below:
| Early Warning Signs | Severe Stage Symptoms |
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Seizures do not have formally defined early and severe stages. Here, “severe stage symptoms” refers to more pronounced symptoms that may occur during or immediately after a seizure.
Diseases Similar to Seizures
Some conditions can cause temporary changes in consciousness, sensation or movement that may resemble a seizure. Syncope and migraine with aura are two such separate conditions that can sometimes exhibit similar symptoms.
A comparative overview is given in the table below to describe the distinct features of the three conditions:
Seizures Vs. Syncope Vs. Migraine With Aura
| Feature | Seizures | Syncope (Fainting) | Migraine With Aura |
| How It Happens | Temporary abnormal electrical activity disrupts normal brain function | Temporary reduction in blood flow to the brain causes loss of consciousness | Temporary neurological changes occur as part of a migraine disorder |
| Location | Brain | Brain function is temporarily affected because of reduced blood flow | Brain and nervous system |
| Associated Symptoms | Staring, unusual sensations, altered consciousness, stiffening or jerking | Light-headedness, blurred vision, weakness, sweating and brief loss of consciousness | Visual changes, tingling, speech disturbance or other neurological symptoms, often followed by headache |
| Severity | Can range from brief episodes to prolonged medical emergencies | Usually brief, although the underlying cause and injuries from falling may be serious | Usually temporary, but symptoms can significantly interfere with daily activities |
| Can It Be Reversed? | Some acute seizures may not recur once the underlying cause is treated; recurrent seizures may require long-term management | Often improves when the underlying cause is identified and treated | Symptoms generally resolve, although migraine attacks can recur |
What Causes Seizures?
A seizure can occur for many reasons. Causes differ between acute seizures and recurrent seizures related to epilepsy.
Possible causes of seizures are listed below:
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Brain Injury: Head trauma can damage brain tissue and may trigger seizures immediately or increase the risk of seizures later.
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Stroke: Stroke-related brain damage can lead to seizures during the acute event or months or years afterwards.
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Brain Infections: Conditions such as meningitis, encephalitis and neurocysticercosis can affect brain function and trigger seizures.
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Structural Brain Abnormalities: Brain tumours, abnormal blood vessels, developmental abnormalities or scar tissue can disrupt normal brain activity.
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Genetic Factors: Some epilepsy syndromes and seizure disorders have a genetic basis, increasing a person's susceptibility to seizures.
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Metabolic Disturbances: Severe abnormalities in blood glucose, sodium or other electrolytes can cause acute seizures.
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Fever in Young Children: Some young children may experience febrile seizures during an illness with fever. These do not necessarily mean the child has epilepsy.
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Alcohol, Medicines and Other Substances: Heavy alcohol use, alcohol withdrawal, certain medicines, drug toxicity or substance use can provoke seizures in some cases.
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Unknown Cause: In some people, no definite cause is identified despite appropriate evaluation.
What are the Complications of Seizures?
A seizure can lead to several life-threatening complications which can affect health in the long term. These complications may include:
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Falls and Injuries: Seizures can lead to sudden loss of consciousness, which can cause sudden falls. This can result in head trauma, cuts or bruises.
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Fractures: In some people, severe muscle contractions can result in broken bones or dislocated shoulders.
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Brain Injury: Recurrent or prolonged seizures can leave the brain deprived of oxygen, leading to cumulative neuronal damage.
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Status Epilepticus: Seizures occurring for more than five minutes or when they happen without recovery from consciousness between episodes can lead to a life-threatening condition called status epilepticus. This can cause brain damage or death.
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Sudden Unexpected Death in Epilepsy (SUDEP): This is a rare complication where a person with epilepsy, who was otherwise healthy, dies without any clear cause. This is often linked with breathing or heart changes during sleep.
What are the Risk Factors for Seizures?
Factors that may increase a person's likelihood of experiencing seizures include:
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Previous Unprovoked Seizure: A previous unprovoked seizure can increase the likelihood of another episode.
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History of Brain Injury: Significant head trauma can increase future seizure risk.
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Previous Stroke: Stroke-related brain damage may predispose a person to seizures.
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Neurological or Developmental Conditions: Certain abnormalities in brain development are associated with a higher risk of seizure.
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Family History: Some types of epilepsy have an inherited component.
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Previous Brain Infection: Infection involving the brain may leave changes that increase seizure susceptibility.
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Brain Tumours or Structural Abnormalities: Structural changes can interfere with normal electrical activity.
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Alcohol Withdrawal or Substance Exposure: Heavy alcohol use, abrupt withdrawal and certain substances may provoke seizures.
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Severe Metabolic Disturbance: Very low blood glucose or major electrolyte abnormalities can trigger acute seizures.
However, having a risk factor does not mean that a seizure will definitely occur.
When Should I See a Healthcare Provider?
A first suspected seizure should be medically assessed to determine whether the episode was a seizure and identify any possible underlying cause.
It is recommended to seek urgent medical attention if:
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A seizure lasts 5 minutes or longer
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Another seizure begins before the person fully recovers
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Breathing does not return to normal
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The person is seriously injured
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The seizure occurs in water
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The person is pregnant
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The person has diabetes and experiences a seizure
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The person does not recover as expected
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A seizure occurs with severe headache, high fever or other concerning neurological symptoms
Repeated or changing seizures also require reassessment of diagnosis and treatment.
How are Seizures Diagnosed?
No single test can confirm every seizure or determine every underlying cause. Diagnosis usually combines information about the episode with neurological examination and selected investigations.
The following tests and assessments may be recommended by doctors to diagnose seizure episodes:
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Medical History and Neurological Examination
The healthcare professional may ask what happened before, during and after the episode. Information from someone who witnessed the event can be particularly useful because the person experiencing the seizure may not remember it. A video recorded safely by a witness can sometimes help with assessment.
The neurological examination evaluates factors such as:
- Strength and movement
- Sensation
- Reflexes
- Coordination
- Mental function
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Electroencephalogram An electroencephalogram (EEG) records electrical activity from the brain through electrodes placed on the scalp. It can help identify patterns associated with epilepsy and assist in classifying seizures. However, a normal EEG does not rule out epilepsy, and an abnormal EEG does not by itself prove that every unexplained episode was a seizure. Longer, sleep-deprived or video EEG monitoring may sometimes be required.
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Brain MRI
MRI provides detailed images of the brain and can identify structural abnormalities such as:
- Tumours
- Previous brain injury
- Stroke-related changes
- Developmental abnormalities
- Areas of scarring
An epilepsy-specific MRI protocol may be recommended after an unexplained or unprovoked seizure.
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CT Scan CT imaging is particularly useful when urgent assessment is needed, such as after a head injury or when bleeding, stroke or another acute structural problem is suspected.
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Blood Tests Blood tests may be used to identify medical problems that may trigger seizures, such as low or abnormal blood sugar levels, electrolyte imbalances, kidney or liver problems and signs of any existing infection. The tests are chosen based on the person’s symptoms and medical history.
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Lumbar Puncture Lumbar puncture may be considered when meningitis, encephalitis or another infection or inflammatory condition affecting the brain is suspected.
Diagnostic Summary Table
| Assessment or Test | What It Assesses |
| Clinical history and witness description | Nature and sequence of the episode |
| Neurological examination | Brain and nervous system function |
| EEG | Electrical brain activity |
| Brain MRI | Detailed structural abnormalities |
| CT scan | Bleeding, injury and other urgent structural abnormalities |
| Blood tests | Glucose, electrolytes and other metabolic abnormalities |
| Lumbar puncture | Infection or inflammation of the nervous system |
How are Seizures Treated and Managed?
Treatment depends on whether the seizure was caused by a temporary medical problem or is part of epilepsy. The following approaches may be used to treat or manage seizures:
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Treatment of an Underlying Cause A seizure caused by a temporary or treatable medical problem may improve once the underlying cause is managed. This may involve correcting very low blood sugar or electrolyte levels, treating a brain infection, managing a stroke or head injury, or treating alcohol withdrawal or medicine-related toxicity. Once the trigger is resolved, long-term antiseizure medicine may not always be needed.
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Antiseizure Medicines
People with epilepsy or a sufficiently high risk of recurrent seizures may be prescribed long-term antiseizure medicines. The choice of medicine depends on:
- Seizure type
- Epilepsy syndrome
- Age
- Other medical conditions
- Pregnancy potential
- Possible interactions with other medicines
- Side-effect profile
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Emergency Treatment A prolonged seizure or repeated seizures without recovery require emergency treatment. Fast-acting medicines may be used to stop prolonged seizure activity, followed by treatment of the underlying cause when possible.
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Epilepsy Surgery Surgery may be considered in selected people with drug-resistant epilepsy, particularly when seizures consistently arise from an area of the brain that can be treated surgically without causing unacceptable neurological harm.
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Device-Based Treatment Implanted stimulation devices may be considered for selected people whose epilepsy remains inadequately controlled despite appropriate medicines.
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Dietary Therapy Specialised dietary approaches may help some people with difficult-to-control epilepsy, particularly in selected children. These diets require professional supervision and are not appropriate for every person with seizures.
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Lifestyle Measures For people with epilepsy, regular sleep, medication adherence, limiting alcohol and recognising individual triggers may help reduce seizure risk.
Common Medicines Used to Treat Seizures
Antiseizure medicines reduce the likelihood of further seizures by altering electrical signalling within the brain. Common medicines that may be used by doctors to treat seizures include:
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Levetiracetam: Used for several focal and generalised seizure types.
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Lamotrigine: Used for selected focal and generalised epilepsies and may be considered for long-term seizure control.
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Valproate: Effective for several seizure types, particularly some generalised epilepsies. However, they require important safety considerations, especially for people who are pregnant or could become pregnant.
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Carbamazepine: Commonly used for certain focal seizures.
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Oxcarbazepine: Often used for focal seizures.
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Topiramate: Used for several seizure types and selected epilepsy syndromes.
Note: Do not start, stop or change an antiseizure medicine without medical advice. Abruptly stopping treatment can provoke seizures or significantly worsen seizure control.
Living With Seizures: Daily Challenges and Caregiving
Recurrent seizures can affect safety, education, employment, travel, independence and emotional well-being. Some of the challenges and essential care points for patients experiencing seizures are listed below:
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Challenges
- Safety Risks: Falls, burns, drowning and other injuries may occur during loss of consciousness or uncontrolled movement.
- Driving: People with seizures may need to follow applicable licensing requirements and medical advice before driving.
- Education and Employment: Frequent or unpredictable seizures can affect attendance, concentration and certain occupational activities.
- Social Difficulties: Misunderstandings about seizures or epilepsy can contribute to stigma and social isolation.
- Emotional Well-Being: Concern about unexpected seizures can cause anxiety and affect confidence or independence.
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Caregiving and Patient Safety
- Protect the Person From Injury: Move nearby sharp, hot or hard objects away and cushion the head if necessary.
- Do Not Restrain Them: Allow seizure movements to occur naturally unless immediate danger is present.
- Do Not Put Anything in the Mouth: A person cannot swallow their tongue, and placing objects in the mouth can cause injury or choking.
- Time the Seizure: Knowing how long the seizure lasts helps determine whether emergency treatment is required.
- Support Recovery: After convulsive movements stop, place the person on their side when appropriate and remain nearby until they recover.
- Know Emergency Warning Signs: Seek urgent help for a seizure lasting 5 minutes or more, repeated seizures without recovery, breathing problems or serious injury.
- Support Medication Adherence: Help the person follow the prescribed medication schedule and attend follow-up appointments.
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Expenses
- Routine Care Costs: These may include neurological consultations, medicines, EEG testing and imaging.
- Long-Term or Specialist Care: People with difficult-to-control epilepsy may require prolonged video EEG, repeated hospitalisation, specialised investigations, surgery or implanted devices.
What is the Prognosis for Seizures?
The prognosis for a seizure mainly depends on its cause and whether further seizures occur. Some people experience a single seizure related to a temporary medical problem and may not have another episode once the underlying cause is treated.
After an unprovoked seizure, the risk of recurrence can depend on EEG findings, brain imaging results, previous brain injury, seizure type and any underlying neurological condition.
Many people with epilepsy achieve good seizure control with appropriate medicines, while others may require additional treatment, specialised assessment, surgery or device-based therapy. Regular follow-up helps ensure that treatment is adjusted as seizure patterns and individual needs change.
How Can I Prevent Seizures?
Not every seizure can be prevented because some arise unexpectedly from genetic, structural or neurological causes.
However, the following measures may help in reducing the risk of seizures:
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Take Prescribed Medicines Regularly: Missing antiseizure medicines can increase seizure risk in people with epilepsy.
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Get Adequate Sleep: Sleep deprivation can trigger seizures in susceptible individuals.
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Avoid Known Personal Triggers: Triggers vary between individuals and may include alcohol, flashing lights in photosensitive epilepsy or missed medication.
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Avoid Harmful Alcohol or Substance Use: Heavy alcohol use and withdrawal can provoke seizures.
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Manage Medical Conditions: Appropriate treatment of diabetes, infections and metabolic disorders can reduce seizures caused by reversible medical problems.
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Attend Regular Follow-Up: Treatment may need adjustment if seizures continue or circumstances change.
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Do Not Stop Medication Suddenly: Abrupt discontinuation can significantly increase seizure risk.
Risk reduction does not guarantee that seizures will never occur.
Seizures Treatment Cost in India
The cost of seizure treatment in India varies according to whether the person requires only outpatient assessment or more extensive investigations, hospitalisation or long-term epilepsy treatment.
People with drug-resistant epilepsy may face substantially higher costs because prolonged video EEG, specialised imaging, pre-surgical evaluation or surgery may be required.
An indicative overview of seizure treatment costs in India is provided in the table below:
| Treatment Component | Approximate Cost in India |
| Neurologist consultation | ₹600 - ₹2,500 per visit |
| Routine EEG | ₹1,000 - ₹3,000 |
| Short-duration video EEG | ₹5,000 - ₹15,000 |
| Prolonged/ 24-hour video EEG | ₹8,000 - ₹45,000 |
| Brain MRI | ₹3,000 - ₹12,000 |
| Monthly antiseizure medicines | ₹300 - ₹4,000, depending on medicine and number of drugs |
| Emergency assessment | ₹2,000 - ₹20,000 |
| Hospitalisation for severe or prolonged seizures | ₹20,000 - ₹1.5 lakh |
| Pre-surgical epilepsy evaluation | ₹50,000 - ₹1.5 lakh |
| Resective epilepsy surgery | ₹1.5 - ₹7 lakh |
| Vagus nerve stimulation | ₹4 - ₹10.5 lakh |
Note: These are approximate price ranges, not fixed charges. Actual costs vary considerably between public and private hospitals, cities, treatment complexity and the length of monitoring or hospitalisation.
Does Health Insurance Cover Seizures in India?
Health insurance policies in India may not directly cover routine treatment for seizures or epilepsy. However, expenses related to associated conditions, complications, hospitalisation or other eligible treatments may be covered depending on the policy. It is best to confirm coverage for seizures with the insurer to know what your insurer will pay or not pay for.
If covered, the insurer will pay for hospitalisation, emergency treatment, diagnostic investigations, specialist services, medicines given during hospitalisation, day care procedures, eligible epilepsy surgery, and pre- and post-hospitalisation expenses. However, the exact coverage may vary from plan to plan.
Routine outpatient consultations, long-term medicines and repeated EEG or imaging performed outside hospitalisation may be covered only if the policy includes OPD benefits.
If seizures or epilepsy were diagnosed or treated before the policy started, it will be considered a pre-existing disease and a waiting period of up to 36 months may apply.
How Much Health Insurance Coverage is Needed for Seizure Treatment?
There is no fixed sum insured required specifically for seizures or epilepsy. The appropriate level of coverage depends on broader healthcare needs, possible hospitalisation and access to specialist neurological care.
Hence, a health insurance coverage of at least ₹10 lakh may cover regular healthcare and hospitalisation expenses resulting from seizure treatment. A higher coverage of ₹15 - ₹20 lakh can provide wider protection against prolonged hospital stays, intensive care, neurological procedures or other major medical expenses resulting from seizure treatment.
People already diagnosed with seizures should also review pre-existing disease terms, waiting periods, co-payments, sub-limits, coverage for seizure surgery or implanted devices and OPD cover where available.
Frequently Asked Questions (FAQs)
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Q1. Can a seizure happen without losing consciousness?
Ans: Yes. Some seizures occur while consciousness remains preserved, while others cause reduced responsiveness or complete loss of consciousness. -
Q2. What is the duration of a typical seizure?
Ans: Many seizures last only seconds to a few minutes. A seizure lasting 5 minutes or longer requires urgent medical attention. -
Q3. What should you do if someone is having a seizure?
Ans: Remove nearby hazards, protect the person's head, time the seizure and stay with them. Do not restrain them or put anything in their mouth.
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References
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https://www.ncbi.nlm.nih.gov/books/NBK430765/
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https://www.cdc.gov/epilepsy/about/types-of-seizures.html
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https://www.ncbi.nlm.nih.gov/books/NBK470442/
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https://pubmed.ncbi.nlm.nih.gov/
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