Akinetic seizure: sudden loss of movement or muscle control

Terminology varies, and clinicians may use more specific seizure classifications after hearing a witness account and reviewing tests. An episode can involve abrupt stillness, a dropped head, loss of posture, a fall, reduced response, or a brief interruption of an activity; not every collapse or pause is a seizure.

A clinician needs to distinguish seizure activity from fainting, heart rhythm problems, low blood glucose, sleep disorders, movement disorders, and other causes of altered awareness or tone. Hypoglycaemia can present with a seizure when glucose becomes dangerously low. Meningitis can present with seizures alongside features such as fever, severe headache, neck stiffness, rash, or altered awareness.

Alcohol-related seizures can occur in a person with alcohol dependence, particularly around abrupt withdrawal, and require medical assessment. These associations describe how the conditions may present; they do not establish the cause of any individual episode.

Protect the person from traffic, water, sharp objects, and falls. Ease them to the ground if possible, cushion the head, loosen tight clothing around the neck, and time the episode. Do not restrain them, put anything in their mouth, or give food, drink, or medicine until they are fully alert.

When movement has stopped, check breathing and place an unresponsive but breathing person on their side. Stay until recovery. Note what happened before, during, and after, including awareness, eye or head movement, change in colour, injuries, and recovery. A video may help a clinician if it can be recorded without delaying first aid or compromising dignity.

Call emergency services for a first suspected seizure, an episode lasting longer than the person's emergency plan allows, repeated seizures without recovery, breathing difficulty, serious injury, a seizure in water, pregnancy, or failure to return toward their usual state. Begin basic life support if they are not breathing normally.

Fever with severe headache, neck stiffness, a non-fading rash, marked drowsiness, or confusion also requires urgent assessment. Someone with diabetes and suspected low glucose needs their established emergency plan followed; do not give anything by mouth while they cannot swallow safely.

Ask what seizure type is being considered, which alternatives need checking, whether an electroencephalogram or brain imaging is appropriate, what safety limits apply to driving, swimming, heights, or machinery, and whether a written emergency plan is needed.