Epilepsy/Seizures

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Prognosis

When a patient has been seizure-free for several consecutive years, it may be possible to discontinue medication, depending on the patient's age and the type of epilepsy. This is only done under the supervision of a physician. As many as three-quarters of adults who have been free of seizures for 3 years remain seizure free after discontinuing drug therapy. More than one-half of children can stop medication without developing seizures.

The prognosis is not as encouraging for those who take more than one antiepileptic drug, have a family history of epilepsy, experience partial seizures, or continue to have abnormal EEGs while on medication.

First Aid

A person experiencing a generalized tonic-clonic seizure or a simple partial seizure that has become convulsive requires first aid. Call an ambulance if the seizure lasts longer than 5 minutes, one seizure follows another without the person regaining consciousness, or the person is seriously injured.

The goals of first aid are to

• prevent injury,
• maintain an open airway,
• provide reassurance to the patient and bystanders,
• recognize an emergency condition, and
• know when to call for help.

Guidelines for helping someone having a seizure:

1. Help the person lie down as soon as possible.

2. Look for a medical alert bracelet, pendant, or wallet card.

3. If a medical alert ID or other documentation indicating that the person has epilepsy cannot be located, call an ambulance.

4. If the person is pregnant or diabetic, call an ambulance.

5. Turn the person onto one side and put a soft object (e.g., pillow, sweater, jacket) under their head. Lying on the side allows secretions to drain from the mouth; prevents the inhalation of secretions; and allows the tongue to fall forward, keeping the airway open. Do not try to hold the tongue.

6. Do not put anything into the person's mouth. During the initial phase of a generalized tonic-clonic seizure, the jaw muscles tighten and it is impossible to open the mouth. Forcing an object into the mouth can damage the jaw or teeth.
   
   
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7. Loosen ties and collars.

8. Remove harmful objects from the immediate area.

9. Do not restrain the person in any way. Restraining while the person is rigid or having convulsions may cause broken bones or bruising. Restraining someone having a complex partial seizure may provoke them into aggressive behavior.

10. Remain with the person until they are completely aware of who they are and their environment, stay calm, and offer reassurance to the person and to bystanders.

Someone having a complex partial seizure may wander or look confused but does not require first aid. It is helpful to calmly and gently guide the person away from harmful objects or situations. Do not attempt to restrain the person.

First aid is not necessary for someone having an absence seizure . They experience a temporary lapse in alertness and need monitoring to ensure their safety.

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