Seizure without shaking: signs and first aid

Someone might stop speaking, fail to follow a request, blink repeatedly, pick at clothing, chew, wander a short distance or show a sudden change in emotion. They may look awake but be unable to respond normally. Afterward, tiredness, headache or confusion can occur. A clinician may also check for triggers such as low blood sugar, alcohol withdrawal or an infection involving the brain; relevant conditions include Hypoglycaemia, Alcohol Use Disorder and Meningitis. One episode cannot establish the cause by itself.

Stay nearby and use short, reassuring sentences. Guide the person away from traffic, stairs, water and machinery without forcing them. Do not shake them, hold them down or put an object in their mouth. Record the time, the first change you noticed, their ability to answer, and how they behaved during recovery. When they are completely alert, explain what you saw and encourage prompt clinical review, particularly after a first event.

Get emergency help if the person cannot breathe normally, does not regain their usual awareness, has repeated episodes, is injured, or the event occurs in water. A first suspected seizure, fever with stiff neck, severe headache, new weakness, pregnancy, diabetes or recent head injury also warrants urgent assessment. Keep the person supervised until help arrives.

Ask what observations support a seizure, whether an ECG, blood tests or brain-wave testing is appropriate, how to reduce immediate risks, and when normal activities can resume.