Seizure management: practical steps for patients and caregivers

If someone has a seizure you need clear, calm actions. Stay with the person, time the seizure, and keep them safe from harm. Move sharp objects away and place something soft under their head. Do not put anything in their mouth or try to hold their limbs down.

Once the shaking stops, roll the person onto their side to help keep the airway clear. Check breathing and call emergency services if the seizure lasts longer than five minutes, if another seizure starts right after, if the person is injured, or if they don’t wake up normally. If this is their first seizure, get medical help.

Medication is the main tool to prevent seizures. Antiseizure drugs like levetiracetam, lamotrigine, valproate and carbamazepine are commonly used. Each drug works differently and has side effects. Work with a neurologist to find the right medicine and dose for you.

Take medicines exactly as prescribed. Missing doses is the most common reason seizures return. Use a daily pill box, set phone alarms, or try a reminder app. If side effects bother you, call your doctor—don’t stop the medicine suddenly.

Know your triggers and avoid them when possible. Common triggers include poor sleep, alcohol, stress, skipped meals, flashing lights, and illness. Keep a seizure diary that records sleep, meds, alcohol, stress, and what happened before a seizure. Diaries help your doctor fine-tune treatment.

For people who keep having seizures despite medicines, other options exist. Vagus nerve stimulation, responsive neurostimulation, and certain diets like the ketogenic diet can reduce seizures for some people. Epilepsy surgery may be an option when seizures come from a single brain area.

Home safety matters. Install padding on sharp corners, use shower chairs, and avoid swimming alone. If you drive, follow local rules—many places require a seizure-free period before you can drive again. Talk to your team about work, school, and activity limits.

Pregnancy and seizures need planning. Some antiseizure drugs increase birth defect risk while others are safer. If you’re planning pregnancy, discuss medicine changes, folic acid, and seizure control with a neurologist and obstetrician.

Teach seizure first aid to family, friends, and coworkers. Simple steps—time the seizure, keep the person safe, turn them on their side, and call for help when needed—make a big difference. Carry an epilepsy ID card or wear a medical alert bracelet.

If seizures change in pattern, become more frequent, or new symptoms appear, contact your care team quickly. Keep regular follow-ups, get blood tests when recommended, and bring your seizure diary to visits. Small changes can prevent big problems.

Reliable resources include epilepsy foundations, local support groups, and reputable medical sites. You don’t have to manage epilepsy alone—use support, plan ahead, and stay connected to your care team.

Make an emergency plan. Share contact numbers, medication list and triggers with caregivers. Put a list on the fridge; save it in your phone. Have school or work action plan so others know what to do after a seizure.