What should you know about fainting spells with seizure activity?

Reduced blood flow during a faint can sometimes cause short, irregular jerks. A seizure may involve sustained rhythmic movements, loss of bladder control, a bitten tongue, unusual behaviour before the event or a longer period of confusion afterwards. These clues overlap, so a description cannot replace assessment. Anaemia, dehydration, hypoglycaemia and atrial fibrillation may contribute to fainting, but they do not establish that seizure activity is present.

Protect the person from nearby hazards and cushion the head with something soft. Do not restrain their movements, put anything in their mouth or give food, drink or medicine. Once movements stop, place them on their side if they are breathing but not fully awake, and stay with them. Note the start and stop times, breathing pattern, movements and recovery. If safe, a witness may record the event for clinicians, while preserving privacy.

Call emergency services if the movements continue, repeat without full recovery, breathing is abnormal, the person is injured, pregnant or has diabetes, or this is a first suspected seizure. Emergency help is also needed for chest pain, severe headache, new weakness or confusion that does not settle. Do not drive the person yourself if they remain unresponsive or breathing is difficult.

Ask whether the event was more consistent with syncope, seizure or another cause, and whether heart monitoring, blood tests or neurological assessment is appropriate. Bring the witness description, medication list and details of posture, warning symptoms, injury and recovery.