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Definition

You have epilepsy. People with epilepsy have seizures. A seizure is a sudden brief change in the electrical and chemical activity in the brain.

After you go home from the hospital, follow the health care provider's instructions on self-care. Use the information below as a reminder.

When You're in the Hospital

In the hospital, the doctor gave you a physical and a nervous system examination and did some tests to find out the cause of your seizures.

What to Expect at Home

Your provider sent you home with medicines to help keep you from having more seizures. This is because the provider concluded you were at risk of having more seizures. After you get home, your provider may still need to change the dosage of your seizure drugs or add new medicines. This may be because your seizures are not controlled, or you are having side effects.

Activity and Lifestyle

You should get plenty of sleep and try to keep as regular a schedule as possible. Try to avoid too much stress. Avoid alcohol as well as recreational drug use.

Make sure your home is safe to help prevent injuries if a seizure takes place:

• Keep your bathroom and bedroom doors unlocked. Keep these doors from being blocked.
• Take showers only. Do not take baths because of the risk of drowning during a seizure.
• When cooking, turn pot and pan handles toward the back of the stove.
• Fill your plate or bowl near the stove instead of taking all of the food to the table.
• If possible, replace all glass doors either with safety glass or plastic.

Most people with seizures can have a very active lifestyle. You should still plan ahead for the possible dangers of a certain activity. Do not do any activity during which loss of consciousness would be dangerous. Wait until it is clear that seizures are unlikely to occur. Safe activities include:

• Jogging
• Aerobics
• Cross-country skiing
• Tennis
• Golf
• Hiking
• Bowling

There should always be a lifeguard or buddy present when you go swimming. Wear a helmet during bike riding, skiing, and similar activities. Ask your provider if it is OK for you to play contact sports. Avoid activities during which having a seizure would put you or someone else in danger.

Also ask if you should avoid places or situations that expose you to flashing lights or contrasting patterns such as checks or stripes. In some people with epilepsy, seizures can be triggered by flashing lights or patterns.

Wear a medical alert bracelet. Tell family, friends, and the people you work with about your seizure disorder.

Driving your own car is generally safe and legal once the seizures are controlled. State laws vary. You can get information about your state law from your provider and the Department of Motor Vehicles (DMV).

Seizure Medicines

Never stop taking seizure medicines without talking with your provider. Do not stop taking your seizure medicines just because your seizures have stopped.

Tips for taking your seizure medicines:

• Do not skip a dose.
• Get refills before you run out.
• Keep seizure medicines in a safe place, away from children.
• Store medicines in a dry place, in the bottle that they came in.
• Dispose of expired medicines properly. Check with your pharmacy or online for a medicine take-back location near you.

If you miss a dose:

• Take it as soon as you remember.
• Check with your provider about what to do if you miss a dose for more than a few hours. There are many seizure medicines with different dosing schedules.
• If you miss more than one dose, talk with your provider. Mistakes are very common, and you may miss several doses at some point. So, it may be useful to have this discussion ahead of time rather than when it happens.

Drinking alcohol or doing illegal drugs can cause seizures.

• Do not drink alcohol if you take seizure medicines.
• Using alcohol or illegal drugs will change the way your seizure medicines work in your body. This may increase the risk of seizures or side effects.

Your provider may need to do a blood test to measure the level of your seizure drug. Seizure drugs have side effects. If you started taking a new drug recently, or your provider changed the dosage of your seizure drug, these side effects may go away. Always ask your provider about the side effects you may have and how to manage them.

Many seizure medicines can weaken the strength of your bones (osteoporosis). Ask your provider about how to reduce the risk of osteoporosis through exercise and vitamin and mineral supplements.

For women during childbearing years:

• If you are planning on becoming pregnant, talk to your provider about your seizure medicines beforehand.
• If you get pregnant while taking seizure medicines, talk to your provider right away. Ask your provider if there are certain vitamins and supplements you should take in addition to your prenatal vitamin to prevent birth defects.
• Never stop taking your seizure medicines without talking to your provider first.

How to Respond to a Seizure

Once a seizure starts, there is no way to stop it. Family members and caregivers can only help make sure you are safe from further injury. They can also call for help, if needed.

Your provider may have prescribed a medicine that can be given during a prolonged seizure to make it stop sooner. Tell your family about this medicine and how to give the medicine to you when needed.

When a seizure starts, family members or caregivers should try to keep you from falling. They should help you to the ground, in a safe area. They should clear the area of furniture or other sharp objects. Caregivers should also:

• Cushion your head.
• Loosen tight clothing, particularly around your neck.
• Turn you on your side. If vomiting occurs, turning you on your side helps make sure you do not inhale vomit into your lungs.
• Stay with you until you recover or medical help arrives. Meanwhile, caregivers should monitor your pulse and rate of breathing (vital signs).

Things your friends and family members should not do:

• DO NOT restrain you (try to hold you down).
• DO NOT place anything between your teeth or in your mouth during a seizure (including their fingers).
• DO NOT move you unless you are in danger or near something hazardous.
• DO NOT try to make you stop convulsing. You have no control over your seizures and are not aware of what is happening at the time.
• DO NOT give you anything by mouth until the convulsions have stopped and you are fully awake and alert.
• DO NOT start CPR unless the seizure has clearly stopped and you are not breathing or have no pulse.

When to Call the Doctor

Contact your provider if you have:

• More frequent seizures than usual, or seizures starting again after being well controlled for a long period.
• Side effects from medicines.
• Unusual behavior that was not present before.
• Weakness, problems with seeing, or balance problems that are new.

Call 911 or the local emergency number if:

• This is the first time the person has had a seizure.
• A seizure lasts more than 2 to 5 minutes.
• The person does not wake up or have normal behavior after a seizure.
• Another seizure starts before the person has fully returned to a state of awareness, after a previous seizure.
• The person had a seizure in water.
• The person is pregnant, injured, or has diabetes.
• The person does not have a medical ID bracelet (instructions explaining what to do).
• There is anything different about this seizure compared to the person's usual seizures.

References

Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 100.

Pearl PL. Overview of seizures and epilepsy in children. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 61.

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