What are the emergency measures for an epileptic seizure?

Written by Wang Xiang Li
Emergency Medicine
Updated on January 11, 2025
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Epilepsy is a chronic disease characterized by transient brain dysfunction caused by sudden abnormal discharge of brain neurons. When a patient has an acute attack, several emergency measures should be taken to prevent injury:

1. During an epileptic seizure, the patient should lie flat, with the head turned to one side or on their side, to keep the airway clear and prevent the inhalation of vomit or secretions into the respiratory tract.

2. Be aware of the surrounding environment to prevent the patient from bumping into tables and chairs, causing secondary injuries. Closely observe the patient's consciousness, breathing, and pulse.

3. Loosen the patient's collar and belt to reduce resistance in the respiratory tract, and place a gauze-wrapped tongue depressor between the teeth to prevent tongue biting and vocalization.

4. Observe whether the patient shows symptoms of increased intracranial pressure and follow medical advice for medication when necessary. Additionally, for persistent epileptic seizures, call emergency services promptly for treatment.

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There are multiple causes of benign epilepsy in children, with significant genetic factors often involved. It generally occurs during a specific developmental period in childhood due to localized diseases, and the prognosis is usually good. Such seizures in children may be caused by conditions like tuberous sclerosis, cerebral trigeminal angioma, and neurofibromatosis. Intracranial infections, such as viral encephalitis, bacterial meningitis, and tubercular meningitis, can also trigger benign epilepsy in children. Therefore, once diagnosed, early intervention treatments should be initiated to prevent the symptoms from worsening. Regular follow-ups with electroencephalograms are also necessary to understand the effects of epilepsy medications and treatments.

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What are the prodromal symptoms of epilepsy?

The prodromal symptoms of epilepsy are diverse, generally involving movement, sensation, and mood. Some patients may experience transient numbness or weakness on one side of their body prior to a seizure, while others may have hallucinations and atypical mental or behavioral changes. However, these symptoms are not necessarily indicative of an impending seizure. When such symptoms occur, it is crucial to consider the possibility of an epilepsy attack, and patients should promptly visit the neurology department of a hospital for a thorough examination, including an electroencephalogram (EEG). If the EEG shows significant abnormalities such as spikes, sharp waves, slow waves, spike-and-wave complexes, or sharp-and-slow wave complexes, it suggests the potential for an epileptic seizure. In such cases, preventive medication should be administered promptly, such as carbamazepine or sodium valproate.

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Epilepsy is a common disease in neurology and includes many types, generally including primary epilepsy and secondary epilepsy. Primary epilepsy refers to cases where the cause is unknown, while secondary epilepsy has a clear cause. Common causes include developmental disorders of the cerebral cortex, tumors, and cerebrovascular diseases, traumatic brain injuries, and central nervous system infections, including encephalitis, meningitis. Cerebrovascular diseases such as cerebral hemorrhage and cerebral infarction can also induce epilepsy. Additionally, certain neurodegenerative diseases, such as motor neuron disease and late-stage Parkinson's disease can also trigger epileptic seizures. Patients with ischemic hypoxic encephalopathy and toxic encephalopathy may also experience epileptic seizures, and some systemic diseases may also lead to epileptic seizures.

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incidence of epilepsy in children

Epilepsy is a common neurological disorder, with the highest incidence in children under the age of one. The prevalence of epilepsy in China ranges from 0.4% to 0.7%, with nine million epilepsy patients, of which six million have active epilepsy. Every day, there are 400,000 new cases of epilepsy, with a prevalence of up to 1% among those aged sixteen and under. There are many children with epilepsy, experiencing various types of seizures, each with its own characteristics, but all share the features of sudden onset, abrupt cessation, and periodicity.