Seizures and the First Seizure Clinic ED

• You have been seen in the Emergency Department with a suspected seizure.

• A seizure (or fit) is a sudden surge of electrical activity in the brain that briefly affects how you feel or act. It can range from a small flicker of a muscle to complete loss of consciousness with uncontrolled movements of your limbs.

• It may be triggered by exhaustion, stress, illness, a knock to the head, pain, overuse of alcohol or use of drugs, as well as lots of different medical causes. Often the cause is never found and 50 percent of people never have another episode.

• This does not mean you have epilepsy. A diagnosis of epilepsy will generally be made after a person has had two or more seizures, on separate occasions.

• Generally, after a first seizure, no immediate treatment is needed and you will likely be sent home. If the cause is uncertain or we feel this episode needs further investigation you will be referred to the neurology service’s First Seizure Clinic. If epilepsy is suspected treatment options will be discussed.

• If you do not receive an appointment within four weeks, please call the booking centre on telephone 0300 303 8360.

• If someone else saw you blackout it is helpful for them to join you at your clinic appointment to explain what they saw or to write down what they saw.

Do not drive.

You will have been told not to drive. For your own safety and the safety of others you must stop driving immediately until you are seen in the first seizure clinic. You will lose control of a vehicle if you have a seizure when driving and you may be prosecuted by the Police if you drive. There are severe penalties, including prison.

Caution with activities.

Following a seizure it is important to take sensible precautions. Suggested precautions include

• Shower instead of taking a bath. If you must take a bath do so in shallow water, with the door unlocked and tell someone.
• Do not bathe children.
• Do not swim unsupervised, and let the swimming pool attendant/ lifeguard know that you may be at risk of seizures.
• Do not do any activities involving heights such as climbing a ladder.
• Do not operate potentially dangerous machinery.
• Avoid standing close to the edge of roads or train platforms.
• Do not ride a bike, particularly in heavy traffic.

Avoid activities where it would be difficult for help to get to you, for example scuba diving, skiing, lone activities.

Use common sense with regard to the activities you take part in, but remember that you may never experience a seizure again. For the majority of people, if you are going to have another episode, it will occur within the next six months.

It is always sensible not to smoke, and to eat a healthy diet, exercise, and avoid excessive stress and tiredness. Limit alcohol intake to 1 to 2 units in 24 hours and avoid recreational drugs.

If you were able to identify what caused/triggered the first episode then you should avoid or minimise the trigger where possible.

It is sensible to tell your line manager or occupational health department that you have had a suspected seizure, so you can discuss if any additional safety measures need to be taken.

You have to inform them if your job involves driving (any vehicle), flying, or you are in the armed forces, police, fire service, merchant navy or if you, or anyone else could be at risk if it happened again, for example if you work at heights, near water, with heat sources or machinery or with children/vulnerable adults.

Advise your friends or family to: o remove nearby harmful objects; o cushion your head

• Only move you if you are in a dangerous place (such as the top of stairs or in the road).
• Stay with you until you fully recover.

They must not put anything in your mouth or try to restrain your movements.

Once the attack has stopped they can roll you into the recovery position to help your breathing. If breathing is still difficult they can check that nothing is blocking your throat like dentures.

Most seizures will stop on their own after a few minutes and no urgent action is needed. However, please seek medical advice. Seek immediate medical attention and call 999,  if

• You are alone and feel unwell.
• If the seizure lasts longer than usual or more than five minutes if this is not known.
• If one seizure follows another without full recovery in between.
• If you have injured yourself or you have difficulty breathing after a seizure.
• If you think you need urgent medical attention.

• For general medical advice please use the NHS website, the NHS 111 service, walk in centres, or your GP.

Epilepsy information.

• Epilepsy Action, www.epilepsy.org.uk. Freephone 0808 800 5050.

• The NHS website www.nhs.uk/Conditions/Epilepsy.

• DVLA guidance, www.gov.uk/epilepsyand-driving.

• Epilepsy Action, telephone 0808 800 5050. www.epilepsy.org.uk.

• Epilepsy Society, telephone 01494 601 400, www.epilepsysociety.org.uk.

This information is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

This article is intended for patients receiving care in Brighton & Hove or Haywards Heath.