Seizures occur when there is a misfiring, or malfunctioning signal in the electrical system of your brain. This signal disrupts your normal brain function, and can have effects like impaired movements or loss of consciousness. There are several types of seizures, and everyone can have different experiences with them. People with recurrent seizures are diagnosed with a condition called epilepsy.

Seizures can be a dangerous medical condition, especially if you don’t know when one is coming. You could fall, or be in an unsafe situation — like driving — when a seizure strikes. Fortunately, many people who experience seizures have warning signs that one is coming. These signs occur during the prodrome or aura phase of a seizure, which can precede the attack.

Seizures occur in stages for most people. Usually, there are four stages, and they are:

  • prodrome
  • aura
  • ictal
  • post-ictal

The prodrome and the aura typically occur just before or at the start of a seizure, and signs vary from person to person. The middle, or active, part of the seizure is the ictal phase, and the period immediately following a seizure is called the post-ictal period.

The body offers a number of warning signs before a seizure occurs, but some are quick or subtle, and can be difficult to recognize.

Prodrome stage

The prodromal phase can last anywhere from 10 minutes to several days before the onset of a seizure. Common symptoms include:

Aura stage

Auras can be another warning sign of a seizure itself or signal the start of a seizure. In some cases, the aura is the seizure itself, often called a simple focal, or partial, seizure. Auras are sometimes called simple focal seizures and occur in one part of the brain. When they spread from that part of the brain to another, other types of seizures — like generalized tonic-clonic (GTC) seizures — may follow.

Most people don’t lose consciousness with simple focal seizures, and people who have auras usually have the same symptoms each time.

Symptoms during an aura, or focal seizure, include:

  • muscle twitches or jerking movements on one side of the body
  • a feeling of déjà vu
  • intense anxiety or fear
  • hallucinations in the form of visions, sounds, or smells
  • changes in blood pressure or heart rates
  • loss of bowel or bladder control
  • numbness or tingling
  • confusion
  • nausea or “butterflies” in your stomach

If you experience warning signs of a seizure or know one is about to occur, the first priority is to make sure you are safe. Below are some tips to take if you know you are going to have a seizure.

  • Avoid driving, ask someone to stay with you, or make sure you are sitting or laying down.
  • If you’re cooking or near open flames, stop.
  • Avoid heights or climbing.
  • If you have children, make sure they’re prepared, or that you have someone with you to care for them during your seizure.
  • Avoid water activities or swimming.
  • If you tend to wander or get confused during or after a seizure, lock the doors of your home, or make sure someone checks on you.

If you’re with someone who indicates they are about to have a seizure, or has signs of an oncoming seizure that you recognize, you can help keep them safe. Maybe the other person begins to shake or breathe differently, or they become suddenly confused. If you’re close to someone who has seizures, chances are you will become familiar with their warning signs. Take the following steps if you have a warning that a seizure is about to begin:

  • Help ease the person to the ground if they are standing.
  • Clear the area of any objects on which they could become injured.
  • Loosen clothing, especially around the neck.
  • Stay with the person for the duration of the seizure.

If you know you or someone else is about to have a seizure, that may give you time to get to a safe position. Seizure safety doesn’t end there, though. Let’s review some safety measures you can take during and after a seizure.

During and after your own seizure

  • Keep a seizure diary and record when you have a seizure, how long it lasts, and what you were doing when it began.
  • Share information on timing, warning signs, and potential triggers of your seizures with your doctor. This may help you take measures to prevent seizures.
  • Be sure you are in a safe place when your seizure begins. Have a seizure action plan.
  • Alert those around you that you are having a seizure.
  • Use any treatments or medications prescribed to you that are meant to stop seizures.

During and after a seizure in someone else

  • Roll the person onto their side to help saliva or vomit drain from their mouth.
  • Do not place anything in the person’s mouth.
  • Check to make sure the person can breathe properly.
  • Record the start time of the seizure and how long it lasts.
  • Stay with the person for the duration of the seizure.

If you’ve been diagnosed with epilepsy or have frequent seizures, you probably don’t need to seek medical care for each episode. If your seizures are limited, and don’t impair your ability to breathe, you can take safety precautions, including recording the duration and your triggers, and follow a safety plan.

Medical emergency

If you or someone else experiences the following during a seizure, call 911 or seek immediate medical attention:

  • difficulty breathing or stopped breathing
  • high fever
  • loss of consciousness that continues after the seizure has ended
  • traumatic injuries from seizure activity
  • seizures last more than 2 minutes
  • if you or the person having the seizure has diabetes
  • if you or the person having the seizure is pregnant
  • if a state of confusion continues for a long period after the seizure has ended

Seizures can come on suddenly and cause the person having them to fall, have difficulty breathing or regaining consciousness, or become injured on objects around them. Most people with epilepsy have warning signs during the prodromal or aura stages of a seizure, allowing extra time to get help. If you or someone you know is about to experience a seizure, there are a number of actions to keep them safe and avoid injury.