You cannot stop a seizure once it starts through any physical action alone. Most seizures end on their own within one to three minutes, and what you do during that time focuses on keeping the person safe until it passes. For people with a known seizure disorder, prescription rescue medications can shorten or stop prolonged seizure activity. The critical threshold to know: any seizure lasting longer than 5 minutes is a medical emergency.
What to Do During a Seizure
If someone near you is having a seizure, especially one involving convulsions or a fall, your priority is preventing injury while the seizure runs its course. Start timing immediately, because that 5-minute mark determines whether you need emergency help.
Ease the person to the ground if they’re falling. Turn them gently onto one side with their mouth pointing toward the ground so saliva or fluids drain out rather than blocking their airway. Clear away furniture, sharp objects, or anything nearby they could strike. Place something soft and flat, like a folded jacket, under their head. Remove their eyeglasses and loosen anything around the neck that could restrict breathing. Stay with them the entire time.
Check for a medical alert bracelet. It may list their condition, medications, and emergency contacts, which can guide your next steps and help paramedics if they arrive.
What Not to Do
Do not put anything in the person’s mouth. This is one of the most persistent myths about seizure care. You cannot swallow your tongue during a seizure, and forcing a spoon, wallet, or any other object between someone’s teeth risks breaking teeth or injuring the gums. Do not hold the person down or try to restrain their movements. Their muscles are contracting involuntarily, and fighting against that can cause injuries to both of you. Do not attempt mouth-to-mouth breathing while the seizure is happening, and do not offer food or water until the person is fully awake and alert.
When to Call 911
Call for emergency help if:
- The seizure lasts longer than 5 minutes
- A second seizure follows shortly after the first
- The person has trouble breathing or does not wake up afterward
- They are injured during the seizure
- The seizure happens in water
- The person has never had a seizure before
- The person is pregnant or has diabetes
A seizure lasting 5 minutes or more is classified as status epilepticus, a life-threatening condition that requires immediate medical intervention to stop the abnormal electrical activity in the brain.
Rescue Medications That Can Stop a Seizure
For people with epilepsy or a known seizure disorder, doctors sometimes prescribe rescue medications designed to be given outside of a hospital. These fast-acting drugs reach the brain quickly and can shorten or stop prolonged seizures and seizure clusters. A caregiver, family member, or the person themselves (if aware) administers them when seizures differ from the usual pattern, happen more frequently than normal, or last longer than typical episodes.
Three FDA-approved options exist for out-of-hospital use in the United States. One is a nasal spray containing midazolam: a single spray into one nostril, with a second spray allowed after 10 minutes if the seizure cluster continues. Another is a nasal spray form of diazepam. The third is a rectal gel form of diazepam, dosed by body weight, which a caregiver administers since the person is typically unable to do it themselves. A second dose of the rectal gel should not be given for at least 4 to 12 hours after the first.
These medications are prescribed in advance with specific instructions for when to use them. If a doctor has prescribed a rescue medication, the person and their caregivers should read the instructions well before they’re needed and discuss exact scenarios that warrant use.
Implanted Devices for Seizure Control
Some people with epilepsy have an implanted device called a vagus nerve stimulator (VNS), a small generator placed under the skin of the left chest that sends regular electrical pulses to the brain through a nerve in the neck. If the person feels a seizure coming on, or if a caregiver recognizes one starting, swiping a special magnet over the generator sends an extra burst of stimulation that may help stop the seizure or shorten it.
The long-term results with VNS improve significantly over time. In the first three months, people experienced roughly a 28% decrease in seizures. After four years, that improvement grew to 58%, and by ten years it reached 75%. Recovery time after individual seizures also tends to be shorter for some people with the device.
Recognizing a Warning Aura
Some people experience a warning phase, called an aura, in the seconds or minutes before a seizure. Auras can include unusual sensations like a strange taste or smell, a rising feeling in the stomach, visual disturbances, sudden intense emotions, or a feeling of déjà vu. Not everyone gets auras, and they don’t happen before every seizure, but when they do occur they provide a narrow window to prepare.
If you recognize an aura, move to a safe location immediately. Sit or lie down on the floor away from hard furniture, stairs, or sharp objects. Alert someone nearby if possible. If you have a prescribed rescue medication, this is the time to use it or ask someone to help you. People with a VNS device can swipe the magnet during this window as well.
What Happens After the Seizure Ends
Once the seizure stops, the person enters a recovery phase that typically lasts between 5 and 30 minutes, though it can stretch to hours or even days after severe episodes. During this time, confusion is common. The person may not know where they are, what happened, or who you are. They may have a headache, feel exhausted, experience muscle soreness, or have difficulty speaking. Some people feel anxious, agitated, or emotionally overwhelmed.
Help them sit in a safe, comfortable place. Speak calmly and explain what happened, because memory gaps are normal. Other physical symptoms during recovery can include coughing, nausea, an elevated body temperature, or loss of bladder control. These are distressing but generally resolve on their own. Do not rush the person to get up or resume activities. Let them rest until they feel alert and oriented, and stay with them until that point.