When should you see a doctor about a first-time seizure?

A seizure is a burst of abnormal electrical activity in the brain. Causes can include fever, low blood sugar, medicines, withdrawal from alcohol or drugs, infection, epilepsy, stroke or a structural brain problem. A seizure can be a presentation of a brain tumour, glioma, glioblastoma or brain metastases, but the event alone does not identify the cause. Assessment may include a neurological examination, blood tests, brain imaging and an electrical recording of brain activity.

Keep the person safe on their side if possible, clear nearby objects, cushion the head and loosen tight clothing. Do not restrain them and do not put food, drink or objects in the mouth. Record what happened before, during and after the event, including movements, awareness, breathing, injury, possible triggers and recovery. Until medically advised, avoid driving, swimming alone, heights and operating machinery.

Call emergency services if the seizure lasts several minutes, another seizure follows before full recovery, breathing remains difficult, the person is seriously injured, the event occurs in water, or they remain unusually confused or unresponsive. Pregnancy, diabetes, a known brain condition or an active cancer diagnosis also lowers the threshold for urgent advice. Even after a brief event with recovery, arrange prompt medical review.

Ask what tests are needed, whether medicines or illness could have contributed, what activities to avoid, and which symptoms should trigger emergency help. Ask whether a specialist referral and follow-up brain imaging are appropriate.