You cannot stop most seizures once they start. What you can do is keep the person safe, time the seizure, and use a prescribed rescue medication if one is available. Most seizures end on their own within one to three minutes, and the best immediate response is protective first aid rather than trying to intervene with the seizure itself.
If the person has epilepsy and carries a rescue medication, that changes things significantly. But for a bystander witnessing a seizure with no medication on hand, safety and timing are your two jobs.
What to Do During a Convulsive Seizure
When someone is having a full-body convulsive seizure (stiffening, rhythmic jerking of the limbs), the priority is preventing injury while the seizure runs its course. Start timing it immediately, either with a clock or your phone.
- Ease them to the ground if they’re standing or sitting and appear to be falling.
- Turn them gently onto one side with their mouth pointing toward the ground. This keeps saliva and any fluid from blocking their airway.
- Clear the area around them. Push away furniture, sharp objects, anything they could strike.
- Put something soft under their head like a folded jacket or sweater.
- Remove their glasses and loosen anything tight around the neck, such as a tie or buttoned collar.
That’s it. You don’t need to do anything else physically. Stay nearby, stay calm, and keep watching the clock.
What You Should Never Do
Two of the most common instincts during a seizure are also the most dangerous: putting something in the person’s mouth and holding them down. Both can cause serious harm.
It is physically impossible to swallow your tongue during a seizure. Placing a wallet, spoon, or finger between someone’s teeth risks breaking their teeth, injuring their jaw, or causing choking. Restraining someone mid-seizure can dislocate joints or cause muscle tears, and it does nothing to shorten the event. Let the seizure run its course. Your role is to protect, not to control.
Rescue Medications That Can Stop a Seizure
For people with diagnosed epilepsy who experience prolonged or cluster seizures, doctors prescribe rescue medications designed to be given outside a hospital. These work by calming the electrical storm in the brain, and they’re the only reliable way to actively stop a seizure before it ends on its own.
The main options available in the U.S. are a nasal spray containing midazolam (approved by the FDA in 2019 for people 12 and older) and a nasal spray form of diazepam (approved in 2020 for ages 6 and up). Both are sprayed into the nostril while the person is on their side. Rectal diazepam has been available longer and remains an option, particularly for younger children. In Europe, a pre-filled oral solution of midazolam is approved for children as young as 3 months. This version is placed inside the cheek (the buccal method), where it absorbs through the tissue without needing to be swallowed.
If someone you care for has a rescue medication, learn how to use it before you ever need it. The nasal sprays are relatively straightforward. Buccal midazolam requires a bit more technique: you lay the person on their side, open their lips, and slowly squeeze or trickle the liquid onto the inside of the lower cheek closest to the ground. The medication absorbs through the cheek lining, so swallowing isn’t necessary.
These medications are only used when prescribed by a doctor for a specific person. They are not something a bystander would carry or administer to a stranger.
Vagus Nerve Stimulator Magnets
Some people with epilepsy have an implanted vagus nerve stimulator, a small device under the skin of the chest that sends regular electrical pulses to the brain to reduce seizure frequency. These devices come with a handheld magnet that can deliver an extra burst of stimulation on demand.
If a seizure begins, slowly swipe the magnet over the device (located on the upper left chest). Repeat once per minute for a total of three swipes. This won’t always stop a seizure, but it can shorten it or reduce its severity in some people. The person with the implant or their caregiver will typically know where the device is and how the magnet works.
When a Seizure Becomes an Emergency
A seizure lasting five minutes or longer is classified as status epilepticus, and it requires emergency medical treatment. This threshold used to be 30 minutes, but guidelines were revised because brain injury can begin well before that point. Five minutes of continuous convulsive activity, or repeated seizures without the person regaining consciousness between them, means calling emergency services immediately.
You should also call for an ambulance if:
- The person does not regain full consciousness after the seizure stops.
- They have difficulty breathing afterward.
- The seizure happens in water.
- The person is pregnant or has diabetes.
- It is their first known seizure.
- They are injured during the seizure.
What to Do After the Seizure Ends
The period right after a seizure is called the postictal phase, and it can be disorienting. The person may be confused, drowsy, or emotional. Some people fall into a deep sleep. Others may not remember what happened or where they are.
Keep them on their side until they’re fully alert. Stay with them, speak calmly, and help them sit up in a safe place once they’re ready. Do not offer food or water until they’ve fully recovered, as their swallowing reflexes may still be impaired. Let them rest as long as they need to.
If possible, note what you observed during the seizure: what time it started and stopped, what the movements looked like, whether the person was conscious or responsive, and how they behaved afterward. This information is extremely useful for their doctor in adjusting treatment or identifying seizure patterns.