What should you know about seizures without convulsions?

A person may suddenly stop responding, stare, blink repeatedly, smack their lips, pick at clothing, wander, or speak in an unusual way. They may report a rising feeling in the stomach, a strange smell or taste, tingling, fear, or a sense that a moment feels familiar. Symptoms can be subtle and the person may not remember them afterward.

Other explanations include fainting, migraine, sleep disorders, low blood glucose, medication effects, or stress-related episodes. A clinician compares the description with an examination and may arrange an EEG or other tests. The appearance of an episode alone cannot confirm its cause.

Speak calmly and guide the person away from traffic, stairs, water, or hot surfaces. Do not argue with unusual behaviour or restrain them. Note whether they respond to their name, how long the change lasts, what happened before it, and how they recover. A short video can help if recording is safe and respectful.

Get emergency help for a first episode, prolonged or repeated unresponsiveness, injury, breathing difficulty, pregnancy, or failure to return to usual awareness. Fever, severe headache, stiff neck, or worsening confusion needs urgent assessment because Meningitis is one possible serious cause. Diabetes or symptoms of Hypoglycaemia also require prompt attention.

Ask whether the observed pattern could represent a focal or absence seizure, what alternatives should be checked, and whether an EEG is suitable. Ask about safety at school, work, driving, swimming, and during sleep while the episodes are being assessed.