Epilepsy

Epilepsy is a very common condition, best described as a rogue electrical discharge across the brain. As the body's functions are controlled by electrical impulses this discharge can lead to a number of physical reactions. Many things may start a seizure (fit): tiredness, stress or flashing lights are common triggers.

Major seizure

This is what most people would recognise as epilepsy, and there are typically four stages:

1. Many people get a sense that a seizure is likely to occur.
2. The electrical impulses lead to a contraction in the muscles that causes the epilepsy sufferer to fall to the ground with a cry. This is known as the tonic phase. The casualty's muscles may then go into spasm. This is known as the clonic stage. During this stage the casualty will not be breathing.
3. When the convulsion is over, the casualty will be in a state of unconsciousness.
4. On recovery from unconsciousness, the casualty will be very sleepy and will want to rest for some time.

Minor fits

There is little for you to do other than to guide the person away from danger and reassure him when he returns to normal.

If he is not aware of any similar episodes happening before, advise him to see a doctor.

First Aid Treatment for a major epileptic seizure

1. During the seizure, do not try to restrain the person. The muscular contractions are so strong during a fit that holding a person down may lead to broken bones - yours and his. Do not attempt to put anything in the mouth. Try to protect the casualty - move sharp objects out of the way, remove constrictions and, if possible, place a soft coat under the head.
2. Once the seizure has finished, check the casualty's airway and breathing and be prepared to resuscitate in the unlikely event that this is necessary. Place the person in the recovery position.
3. When the casualty comes round, reassure him. He may have lost control of bowel or bladder function so cover him up and, when he is steady on his feet, help him to find somewhere to clean up. He is likely to be very tired so, if possible, find him somewhere to lie down and sleep. Most of all, ask him what he wants to do - most epileptics manage the condition very well and will have their own coping strategies.

Infantile convulsions (Caused by heat)

Babies and young children may have seizures induced by a high temperature. This may be the result of an infection or because they are overwrapped and in a warm environment. The signs and symptoms are similar to a major epileptic seizure.

Treatment

Make sure that the child is protected from hitting himself on a bed or cot - do not attempt to restrain. Cool down by removing bedclothes and clothing where possible. Sponge the head and under the arms with a tepid flannel or sponge, re-soaking it regularly. When the convulsion is finished, check ABC and take action as appropriate. In most cases, the child will want to sleep. Dress him in dry clothes and let him sleep. Call a doctor for advice.

When to call an ambulance

Generally, neither epilepsy nor infantile convulsion are medical emergencies. However, you should be prepared to call an ambulance if:

• The casualty is injured during the seizure.
• The seizure lasts for longer than 3 minutes.
• There are repeated seizures in a short period of time.
• The casualty does not regain consciousness.

If it is the first seizure, advise the casualty to call his doctor or take him to hospital.