How to deal with emergency situations in epilepsy

A seizure is considered an emergency when it lasts a long time or when seizures occur close together and the person doesn't recover between seizures. Just like there are different types of seizures, there are also different types of emergencies. Some people may have easy to control seizures and never have emergency situations. However, there are some factors that may make you more likely to have uncontrolled seizures and seizures emergencies. It’s important to know if any of these situations pertain to you and to talk to your doctor about your risks.

Who are at risk for a seizure emergency?

Some situation may results in seizure emergency. If you fall in the below situation, or if you answer yes to any of these questions, talk to your health care team about your risks for emergencies and what to do next.

Have you ever....

• Been diagnosed with status epilepticus?
• Had one seizure after another?
• Had clusters of seizures over a number of hours or days?
• Had a generalized seizure lasting 5 minutes or longer?
• Had long partial seizures or periods of confusion?
• Started or stopped medicines without medical advice?
• Poorly controlled seizures?
• A known cause of seizures, such as infection, stroke, brain tumor?
• Problems remembering medicines?
• Difficulty taking medicines on a consistent schedule?
• Problems affording medicine?
• Seizures during sleep?
• Live alone?
• Low blood levels of medicine?
• More seizures during medicine changes?
• Taking many seizure medicines?

Do you have...

Warning Signs

Seizures Are Usually…

• Unpredictable - you often can't predict when and where a seizure may happen
• Episodic - seizures can come and go
• Brief - usually last only seconds to a few minutes
• Stereotypic - symptoms are similar whenever they occur

Now, consider the different feelings or behaviors that may occur at the beginning, middle or end of a seizure. Sometimes these symptoms may be considered a warning to a seizure or are part of the seizure itself. If any of these symptoms are present, start keeping track of what occurs and share it with your doctor. Some warning signs of possible seizures may include:

• Odd feelings, often indescribable
• Unusual smells, tastes, or feelings
• Unusual experiences – "out-of-body" sensations; feeling detached; body looks or feels different; situations or people look unexpectedly familiar or strange
• Feeling spacey, fuzzy, or confused
• Periods of forgetfulness or memory lapses
• Daydreaming episodes
• Jerking movements of an arm, leg, or body
• Falling
• Tingling, numbness, or feelings of electricity in part of the body
• Headaches
• Unexplained confusion, sleepiness, weakness
• Losing control of urine or stool unexpectedly

How to Prevent?

Preventing seizures and other problems must be part of seizure management. This means working together with your health care team to control seizures as best as possible. Ways to prevent seizures and other problems must include taking seizure medicines regularly as problems taking medicines is one of the biggest risks for uncontrolled seizures. People can also adjust their lifestyle and environment to reduce the chance of seizures. Steps then can be taken to address risk factors for seizures and other problems.

What to do to avoid these problems?

Consider a few examples of how to prevent other problems:

• Avoiding alcohol and other substances and managing stress may help seizure control and lessen the risk of mood disorders.
• Keeping good seizure control and avoiding side effects of medicines may help prevent or lessen cognitive problems, mood changes and falls.
• Keeping a regular sleep schedule can help prevent seizures from poor sleep and help treat sleep disorders and stress.
• Choosing seizure medicines carefully can help lessen the risk of bone problems, (thinning of the bones or osteoporosis) or developing hormonal problems. These hormonal problems could affect having children or cause other health problems.
• Taking Vitamin D and exercising can help keep bones strong and hopefully decrease fracture
• Wearing protective helmets can lessen the chance of head injury.

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