Seizures and epilepsy: put nothing in the mouth — time it instead

The two things done most wrongly, said straight away: forcing a spoon, chopsticks or a cloth into the mouth of someone having a seizure, and holding their limbs down. According to CDC neither must be done — and a person having a seizure cannot swallow their tongue. The most useful thing to do is far simpler: time it, and stay beside them.

Recognising it: not every seizure is a dramatic convulsion

According to CDC, the picture everyone remembers — falling down, the whole body convulsing, loss of consciousness — is not the commonest kind. Milder seizures tend to get put down to trúng gió (a local folk term for a sudden chill) or to inattention.

• WHOLE-BODY CONVULSION: the body stiffens then jerks rhythmically on both sides, with loss of consciousness. According to CDC, afterwards the person is usually confused and exhausted.
• STARING BLANKLY: sitting motionless, eyes blinking rapidly, pointless chewing movements, then it is over. In children this is very easily read as poor concentration.
• NO ANSWER WHEN SPOKEN TO: according to CDC there is a kind of seizure in which the person is confused, smacks their lips, picks at their clothes and does not answer for a few minutes, then remembers none of it.
• TWITCHING ON ONE SIDE: only one hand or one side of the face jerks, while the person stays awake and knows what is happening.

What to do while someone is having a seizure

1. START TIMING from the moment the seizure begins. According to CDC, a seizure lasting longer than 5 minutes is the point to call emergency services — without a measurement every seizure feels endless and you cannot make that judgement.
2. Help them to the floor if they are standing and about to fall. Do not lift them onto a bed; someone convulsing easily rolls off it.
3. Move hard objects, table corners, the flask of hot water and the stove out of reach — this is the single most effective thing for preventing injury.
4. Put something soft and flat under the head; a folded jacket is enough. Take off glasses, loosen anything tight at the neck.
5. Once the seizure has stopped: gently roll them onto their side with the face tilted slightly down, so saliva and vomit run out rather than into the lungs.
6. STAY until the person is fully alert and talking normally. Speak calmly and tell them what just happened — they remember none of it and are often very frightened.

What NOT to do — where the harm is done

• Do NOT put anything into the mouth: a spoon, chopsticks, a cloth, your fingers. According to CDC this injures the teeth and the jaw.
• Do NOT squeeze lemon into the mouth, pour in water or push in medicine. According to CDC, give nothing to eat or drink until the person is fully alert — liquid at this moment runs straight into the lungs.
• Do NOT hold the limbs down or pin the person to stop the seizure. According to CDC this must not be done; holding someone down does not shorten a seizure, it dislocates joints and cracks bones.
• Do NOT give rescue breaths while the convulsion is going on, even if the lips are blue — according to CDC, no artificial respiration during a seizure. But if the seizure HAS STOPPED and breathing is still difficult, or the person does not come round, call emergency services.
• Do NOT use coin-rubbing (cạo gió), skin-pricking to let blood (chích lể) or balm on the temples: none of it shortens a seizure, and it takes the time you should be spending on timing it and clearing the space.

When you must call emergency services

Not every seizure is epilepsy

According to CDC, epilepsy is a brain condition that causes REPEATED seizures — so a single isolated seizure is not yet epilepsy. Many seizures have a temporary cause: low blood sugar, a head injury, poisoning, alcohol withdrawal, an infection of the nervous system. That is why a first seizure always has to be investigated.

In young children, febrile seizures are a situation of their own and a very common one. With a stiff neck, drowsiness or a bulging fontanelle alongside, read the articles on meningitis and Japanese encephalitis as well — two causes that have to be ruled out.

Epilepsy is a treatable condition

According to CDC, many people with epilepsy control their seizures with treatment and live ordinary lives — the goal is not endurance but control. CDC stresses two things: take the medication EXACTLY as the doctor prescribed it, and ask the doctor before adding any other medicine or supplement.

Stopping medication is one of the seizure triggers CDC names, along with lack of sleep, stress and alcohol — so do not stop on your own because it has been a long time since the last seizure. Keep a record of every seizure: the date, the time, how long it lasted, whether there had been lost sleep or a missed dose beforehand. CDC also advises against swimming alone.

If someone is having a seizure in front of you now, call 115 or take them to the nearest medical facility — this is precisely the situation Y Te Xanh (GreenCare) states is not for a remote consultation. What we can do is before and after the seizure: a remote consultation so the family can decide between hospital and waiting; a doctor coming to the house to take a history and examine; and nursing care and rehabilitation at home after discharge.

The first-aid steps, the things not to do, the signs for calling emergency services and the seizure triggers in this article follow the public materials of the US CDC; the section on febrile seizures in children follows NIH. The sign of one-sided weakness after a seizure is not on CDC's list. This article passes that on and does not replace being examined. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.