A seizure is a brief episode of abnormal electrical activity in the brain that temporarily interrupts normal function. This sudden surge of electrical signals can manifest in a wide variety of ways, including changes in movement, behavior, and awareness. For a bystander, the sounds produced during a seizure are an immediate indicator that something is wrong. Seizure-related sounds vary significantly depending on the type of seizure, often providing important clues about the physiological processes occurring inside the body.
The Initial Sudden Vocalization
The most dramatic sound associated with the onset of a generalized tonic-clonic seizure is often called the “ictal cry” or “epileptic cry.” This is a sharp, involuntary vocalization that occurs in the seizure’s tonic phase, not an expression of pain or distress. The sound is generated when the muscles of the chest and diaphragm undergo a powerful, sustained contraction, forcing a large volume of air rapidly out of the lungs.
This forced rush of air passes through the vocal cords, which are simultaneously constricted due to the generalized muscle rigidity. The resulting sound is a sudden, high-pitched cry or moan that occurs immediately as the person loses consciousness and collapses. Its presence is strongly associated with true epileptic generalized tonic-clonic seizures.
Respiratory Sounds During Seizure Activity
As the seizure progresses from the initial stiffening (tonic phase) into the rhythmic jerking (clonic phase), the sounds shift to those related to disordered and noisy breathing. The alternating muscle contractions of the clonic phase affect the respiratory muscles, causing breathing to become labored and intermittent. This results in distinctive sounds like deep, guttural gasping, grunting, or snoring.
Airway obstruction contributes to these noises, often because the tongue relaxes or is displaced backward. Saliva can also accumulate, leading to gurgling or frothing sounds around the mouth. Breathing may temporarily cease entirely during the tonic phase, which can cause the skin and lips to appear dusky or blue. Breathing typically resumes spontaneously in the clonic phase with the noisy, labored sounds.
Non-Vocal Physical Noises
Beyond the sounds of breathing and vocalization, a seizure produces mechanical noises resulting from the body’s physical activity and interaction with its surroundings. The involuntary clenching of the jaw muscles can lead to bruxism, which is the audible grinding or clenching of the teeth. This jaw tension often causes a bitten tongue or cheek, which may introduce a distinctive, wet sound into the respiratory noises.
The rhythmic contractions of the limbs and body during the clonic phase create sounds as the body strikes the surface it is lying on or any nearby objects. This can range from loud thumping or banging as arms and legs jerk against the floor to lighter tapping sounds. If the person falls suddenly at the onset of the seizure, the heavy impact sound of the collapse is often the first auditory cue a bystander receives.
Immediate Response When Seizure Sounds Occur
Recognizing any of these sounds should prompt immediate, protective action from a bystander to prevent injury. First, gently ease the person to the ground, if necessary, and clear the immediate area of any hard or sharp objects the flailing limbs might strike. The person should be turned onto their side into the recovery position, which helps saliva and other fluids drain from the mouth, keeping the airway clear.
A soft, flat item, such as a folded jacket or sweater, should be placed beneath the head to cushion it from impact with the floor. Avoid restraining the person or putting anything into their mouth, as this can cause harm. The duration of the seizure must be timed, and emergency services should be contacted immediately if the episode lasts longer than five minutes, if breathing does not resume, or if the person is injured.