You cannot stop a seizure once it starts. No action, medication, or technique available to a bystander will end a seizure in progress. What you can do is keep the person safe until the seizure ends on its own, which most do within one to three minutes. Your job is protection, not intervention.
What to Do During a Seizure
The core steps are simple: stay, keep them safe, and turn them on their side.
- Ease them to the ground if they’re standing or appear to be falling. Don’t try to catch them mid-fall in a way that puts you at risk.
- Clear the area around them. Move chairs, sharp objects, or anything hard away from their body. You’re creating a safe zone, not moving the person.
- Place something soft and flat under their head, like a folded jacket or sweater, to prevent repeated impact against the floor.
- Turn them gently onto one side with their mouth pointing toward the ground. This keeps their airway clear so saliva or vomit drains out instead of blocking their breathing.
- Start timing the seizure. Check a clock or start a timer on your phone. Duration matters for deciding whether to call emergency services.
Stay with the person the entire time. Don’t leave to get help unless someone else can take over. Speak calmly to others nearby and ask them to give space.
What Not to Do
The most common instincts people have during a seizure are, unfortunately, the wrong ones.
Do not put anything in their mouth. A person cannot swallow their tongue during a seizure. Their jaw and face muscles may clamp down hard, and if something is between their teeth, they can break it and choke on the pieces, or shatter their own teeth. Don’t offer water, food, or pills until the person is fully awake either. Anything swallowed while consciousness is impaired can go into the lungs.
Do not hold them down or restrain their movements. Restraining someone does not shorten or stop a seizure. It can cause injuries to both of you, and it often makes the person more confused, agitated, or aggressive as they start to come out of it. People don’t fight intentionally during or after a seizure, but if they feel restrained while disoriented, they may react defensively.
Do not attempt CPR. Breathing may look irregular or pause briefly during a convulsive seizure, but it typically resumes on its own. CPR is only appropriate if the person is not breathing after the seizure has fully ended.
When to Call Emergency Services
Most seizures do not require an ambulance. But call 911 (or your local emergency number) if:
- The seizure lasts longer than 5 minutes
- The person does not regain consciousness or has a second seizure without waking up in between
- The person is pregnant, has diabetes, or has no known history of seizures
- The seizure happened in water
- The person is injured during the seizure
- The person has difficulty breathing after the seizure ends
A seizure lasting more than 5 minutes is a medical emergency called status epilepticus, and it requires professional treatment to stop safely.
What Happens After the Seizure Ends
When the convulsions stop, the seizure isn’t really “over” for the person experiencing it. What follows is called the postictal phase, a recovery period that typically lasts 5 to 30 minutes but can sometimes stretch longer. During this time, the person may be confused, drowsy, disoriented, or unable to speak clearly. Headache and nausea are common. Some people cough, spit, or drool excessively. A few become briefly agitated or emotional without understanding why.
Your role during this phase is to stay calm and present. Keep them on their side until they’re fully alert. Speak in a quiet, reassuring voice. Tell them who you are, where they are, and what happened. Don’t overwhelm them with questions. Many people have no memory of the seizure itself and may feel embarrassed or frightened when they realize what occurred. Give them time and privacy if possible.
Temporary weakness on one side of the body can also happen after a seizure. This resolves on its own and doesn’t necessarily mean a stroke has occurred, though if you’re unsure, it’s reasonable to seek medical evaluation.
What to Observe and Write Down
If someone you know has epilepsy, detailed notes about each seizure are extremely valuable for their doctor. If you’re a bystander, even a few details can help paramedics or emergency physicians. Try to note:
- Time and duration: When did it start and how long did it last?
- Body movements: Did jerking start on one side and spread to both? Did the body stiffen, go limp, or both in sequence? Did the head or eyes turn to one side?
- Awareness: Could the person respond to their name or follow simple commands at any point, or were they completely unresponsive?
- Other signs: Staring, lip-smacking, chewing motions, skin color changes, loss of bladder control, unusual breathing patterns.
- Recovery: How long before the person could speak, recognize you, or remember where they were?
Recording video on your phone, if you can do so without neglecting the person’s safety, gives healthcare providers information that’s nearly impossible to capture in words. Where the seizure starts in the body and how it spreads offers clues about where it originates in the brain.
Rescue Medications for Known Epilepsy
Some people with epilepsy carry prescribed rescue medications designed to be given by a family member, caregiver, or trained bystander when a seizure meets specific criteria set by their doctor. These are not something you’d use on a stranger. They’re part of an individualized seizure action plan.
These medications come in forms that don’t require an IV or a medical professional: nasal sprays, solutions placed inside the cheek, and rectal gels. The person’s doctor will have defined exactly when to use them, such as after a certain number of seizures within a specific time window, or if a seizure exceeds a set duration. If you’re a caregiver for someone with epilepsy, make sure you’ve reviewed their action plan and practiced the steps before you ever need them.
Reducing the Risk of Future Seizures
For people living with epilepsy, several everyday factors directly affect how often seizures occur. The most impactful ones are within a person’s control.
Sleep deprivation is one of the most reliable seizure triggers. It lowers the threshold at which the brain’s electrical activity becomes disorganized. Consistent sleep schedules matter more than total hours; irregular patterns are particularly risky.
Stress is another major trigger, and people with a history of anxiety, depression, or trauma are more likely to have stress-triggered seizures. The encouraging side of this: stress reduction techniques have been reported to meaningfully lower seizure frequency in people who identify stress as a personal trigger. Approaches vary, but regular physical activity, mindfulness practices, and adequate mental health support all play a role.
Medication consistency is the single most important factor for people who take anti-seizure drugs. Missing doses, taking them at irregular times, or stopping medication without medical guidance can provoke breakthrough seizures even in people whose epilepsy is otherwise well-controlled. Setting phone alarms, using pill organizers, and building medication into a fixed daily routine are small steps with outsized impact.
Alcohol, flickering lights, illness, and dehydration are other commonly reported triggers, though they vary significantly from person to person. Keeping a seizure diary that tracks sleep, stress, meals, and medication timing helps identify individual patterns over time.