Seizures and fits

Epilepsy is the underlying condition causing most seizures that repeat and persist. Other causes include a head injury, stroke, brain tumor, or a brain infection such as meningitis.

They can also occur due to low oxygen, low sodium or blood sugar levels, alcohol or drug poisoning, or as a side effect of certain medications.  These are more likely to be seizures related to a particular episode, and they stop once the cause is treated, such as normalizing the level of sodium in your blood.

Seizures appear suddenly and may be very obvious to those around them, or they may be subtle. The first time requires medical attention, but for those with repeated seizures, those that know them best may grow attuned to more subtle signs that they are having a seizure.

The only indication some may feel after having a seizure is feeling very tired, spaced out, head-achy or confused. People may experience a sudden loss of consciousness or responsiveness. They may collapse to the floor, their bodies rigid, and a limb or the head may be jerking and shaking. They may salivate or bite their tongue or have a loss of bladder and bowel control. It can be distressing to see and frightening if this is the first seizure.

Most people will not remember the seizure and may have no memory for a good while afterward, perhaps 30 to 60 minutes.

If you have a fit, the doctors will refer you urgently to an emergency department to identify the cause of your seizure. They will arrange blood tests, looking for any medical conditions that might be causing seizures, such as diabetes or low sodium.

At the hospital, they may arrange several tests, such as an electroencephalogram (EEG) recording of brain activity. An MRI, a brain scan, may also be ordered to evaluate the brain’s structure and identify any areas of damage. These tests do not rule in or out epilepsy but can help provide a possible cause or type of epilepsy, and – importantly – they exclude certain other causes too.

An EEG is a painless procedure whereby small sensors are placed on your scalp to record the brain's electrical activity on a computer. It only indicates what's happening at the testing time, so it may miss past or future epileptic activity – it's best done during a seizure to capture a particular pattern.

If you have any type of seizure, you must stop driving and inform your state’s Department of Motor Vehicles (DMV). This is because there is a risk you could have a seizure while driving, putting both yourself and others in serious danger. The DMV has certain rules about taking up driving again once you’ve been evaluated and diagnosed and have been seizure-free for a certain period.

Similarly, you may need to discuss any seizure evaluations with your employer if your job requires sustained concentration, with a risk to yourself or others if you have a lapse in concentration. Operating heavy machinery is one example.

You also shouldn't swim or have a bath unattended until you have been assessed by a specialist, as a seizure during this time could cause drowning.

Once you are under a specialist team with a diagnosis, they can advise further about potential risks and keeping you safe.