What should you know about a seizure diary?

A seizure diary is a simple record of episodes, warning symptoms, possible triggers, treatment doses and recovery details; it helps your clinician identify patterns and assess whether your care needs review. You can keep it in a notebook, phone app or another format that is easy to update soon after an event. A family member, friend or colleague may need to add observations when you cannot remember the episode yourself.

Record the date and time, where the event happened, what you noticed before it, and what the movements or changes in awareness looked like. Include how long the event seemed to last, whether there was an injury, and how you felt afterwards. Note sleep loss, illness, alcohol use, missed or late medicine, unusual stress, flashing lights or other circumstances that may have preceded it. These entries do not prove a cause, but they give your clinician a clearer account than memory alone. A note about recovery—such as confusion, headache, weakness or a return to your usual self—can also help distinguish changes between episodes.

Use the same headings each time and write an entry even when an event is uncertain. Ask a witness what they saw, rather than filling gaps with guesses. Keep a current list of prescribed medicines, doses and any recent changes, and mark missed doses or side effects. If it is safe and appropriate, a witness may record a video for the clinician, while protecting your privacy and never delaying first aid. Bring the diary and medicine list to appointments. Do not change or stop seizure medicine based only on diary entries; discuss patterns with the prescriber.

Call emergency services if a seizure lasts longer than five minutes, another seizure starts before the person has recovered, breathing does not return normally, or the person has a serious injury. Urgent assessment is also needed for a first suspected seizure, an episode in water, or a seizure during pregnancy. Place the person on their side when possible, clear nearby hazards, cushion the head, and time the event. Do not restrain them and do not put anything in their mouth. A seizure with fever, severe headache, stiff neck or a new rash needs prompt medical attention because it may occur with meningitis. Episodes associated with very low blood sugar or withdrawal from heavy alcohol use also need urgent assessment; see information on Hypoglycaemia and Alcohol Use Disorder for related context.

Ask which details matter most for your type of episode, whether a witness account or video would help, and which changes should prompt a same-day call. You can also ask how to record missed medicine, whether your treatment plan needs review, and what an individual emergency plan should say. If you drive, work at heights or operate machinery, ask what safety restrictions apply while the cause of an episode is being assessed.