Head shaking in sleep that looks like a seizure

Notice whether the movement is rhythmic, how long it lasts, whether the person responds, and what happens before and afterwards. A seizure may involve stiffening, jerking, a fixed gaze, loss of awareness, tongue injury, loss of bladder control or prolonged confusion, but not every episode has all of these features. Low blood sugar, alcohol withdrawal and infections such as meningitis can also be associated with abnormal movements or altered awareness. A description cannot confirm the cause, especially when the event happened during sleep.

Keep the person away from hard or sharp objects, cushion the head, loosen tight clothing and place them on their side when the movements stop if they are breathing normally. Do not hold them down, put anything in their mouth, give food or drink, or try to wake them by force. Time the event. If safe, record a video that shows the whole body and the surroundings, and write down sleep, illness, alcohol, medicines and food intake beforehand.

Call emergency services if the event lasts unusually long, repeats without recovery, causes injury, affects breathing, occurs in water, or is the first suspected seizure. Urgent help is also needed for fever with a stiff neck, severe headache, confusion, a new weakness or difficulty waking. Arrange medical review after any unexplained episode, even if the person seems well afterwards.

Ask whether the description suggests a seizure or a sleep-related movement, whether medication or blood-sugar review is needed, and whether further neurological or sleep assessment should be arranged. Bring any video and the timing notes.