Management of tonic-clonic seizure lasting less than 5 minutes

Acutely, during a tonic-clonic seizure:

• there should be clear space around the patient
  
  
• place some support under the person’s head and neck (a cushion a folded coat or support the head with another person hand)
  
  
• loosen any tight neckwear, belts etc. and also remove any spectacles
  
  
• place the patient in the recovery position and aid general recovery once the seizure has taken its course; wipe away any excess mucus and check their airways and breathing. Ensure that the patient cannot hurt themselves
  
  
• seizure duration should be timed
  
  
• bystanders should not
  • move the patient except in circumstances where he or she is in danger of further injury e.g. from fire or traffic
  • place anything in the mouth or give anything by mouth
  • restrict the movement of the patient or lift the patient (1)
    
    
• emergency treatment should be sought in cases where
  • a single seizure persists for longer than 5 minutes or 2 minutes longer than what is normal for that person
  • the person does not regain consciousness
  • there are multiple seizures (three or more seizures in an hour)
  • an injury has occurred to the person
  • the person may have inhaled water
  • breathing difficulties continue
  • it’s the persons first seizure (1,2)

Reference:

• (1) Epilepsy Action 2005. The role of primary care in epilepsy management 2.
• (2) Epilepsy Research UK. What to do when someone has seizures